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General NPI Number Information
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NPI Number | 1720170319
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL CONSULTANTS INC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 350 SOUTHMONT BLVD
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City | JOHNSTOWN
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State | PA
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Zip | 15905-2818
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Country | US
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Telephone | 814-535-2511
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Fax | 814-535-8473
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Provider Business Mailing Address
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Address Line | 350 SOUTHMONT BLVD
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City | JOHNSTOWN
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State | PA
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Zip | 15905-2818
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Country | US
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Telephone | 814-535-2511
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Fax | 814-535-8473
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD C LEIB JR
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Credential | M.D.
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Telephone | 814-535-2511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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