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General NPI Number Information
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NPI Number | 1568761690
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Entity Type | Organization
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Legal Business Name | GI SURGERY ASSOCIATES
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Dates
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Enumeration Date | 03/15/2011
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 204 POMPANO DRIVE S.E. 18TH MEDICAL GROUP
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City | ST. PETERSBURG
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State | FL
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Zip | 33705
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Country | US
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Telephone | 704-582-1820
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Fax | 704-919-5000
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Provider Business Mailing Address
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Address Line | 204 POMPANO DR SE 18TH MDG MEDICAL GROUP
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City | ST PETERSBURG
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State | FL
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Zip | 33705-6403
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Country | US
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Telephone | 704-582-1820
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Fax | 704-919-5000
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. JOHN M THOMAS
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Credential | MD PHD
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Telephone | 704-582-1820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865X1600X
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Taxonomy Name | Operational (Transportable) Military General Acute Care Hospital
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License Number | 15731M
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License Number State | CA
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