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General NPI Number Information
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NPI Number | 1770718405
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Entity Type | Organization
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Legal Business Name | MID-SOUTH GASTROENTEROLOGY ASSOC PC
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 1510 1/2 HATCHER LN
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City | COLUMBIA
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State | TN
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Zip | 38401-4825
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Country | US
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Telephone | 931-381-7818
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 131149
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City | BIRMINGHAM
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State | AL
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Zip | 35213-6149
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Country | US
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Telephone | 877-319-7141
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Fax | 877-243-2920
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Authorized Official
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Title or Position | CHAIRMAN CORP
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Name | AMIT A CHOKSI
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Credential | MD
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Telephone | 931-388-8302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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