MEDICARE: GASTROINTESTINAL ASSOCIATES, PA

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598482440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GASTROINTESTINAL ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	2510 LAKELAND DR
Second Line	:
City	:	FLOWOOD
State	:	MS
Zip	:	39232-9513
Country	:	US
Telephone Number	:	601-355-1234
Fax Number	:	601-326-3566

Provider Business Practice Location Address
First Line	:	7127 HWY 98 W
Second Line	:	SUITE 10
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-7034
Country	:	US
Telephone Number	:	601-268-5185
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JAMES J WEBER
Credential	:	MD
Telephone Number	:	214-424-2213

Provider Enumeration Date	:	10/21/2022
Last Update Date	:	01/25/2023

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