MEDICARE: CATALINA GASTROENTEROLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	AZ31258	AZ

General Provider Information

NPI Number	:	1194917492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATALINA GASTROENTEROLOGY

Provider Business Mailing Address
First Line	:	PO BOX 36205
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85740-6205
Country	:	US
Telephone Number	:	520-297-3911
Fax Number	:	520-297-3955

Provider Business Practice Location Address
First Line	:	1845 W ORANGE GROVE RD
Second Line	:	#125
City	:	TUCSON
State	:	AZ
Zip	:	85704-1134
Country	:	US
Telephone Number	:	520-297-3911
Fax Number	:	520-297-3955

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. CHRIS W. COLLINS
Credential	:
Telephone Number	:	520-297-3911

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	08/10/2007

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Directions to “CATALINA GASTROENTEROLOGY ” Practice Location

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