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General NPI Number Information
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NPI Number | 1356694723
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN GASTROENTEROLOGY LLC
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 681 GOODLETTE RD N STE 130
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City | NAPLES
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State | FL
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Zip | 34102-5458
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Country | US
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Telephone | 239-649-1037
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Fax | 239-649-5879
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Provider Business Mailing Address
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Address Line | 681 GOODLETTE RD N STE 130
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City | NAPLES
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State | FL
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Zip | 34102
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Country | US
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Telephone | 239-649-1037
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Fax | 239-649-5879
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH P HUSSEY
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Credential | MD
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Telephone | 239-649-1037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME46740
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License Number State | FL
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