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NPI Code Detail

MEDICARE: MANHATTAN GASTROENTEROLOGY LC

MEDICARE: MANHATTAN GASTROENTEROLOGY LC
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
1207RG0100XGastroenterology Physician04-23652KS

General Provider Information

NPI Number : 1720397110
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANHATTAN GASTROENTEROLOGY LC
Provider Business Mailing Address
First Line : 3712 PULLMAN LNDG
Second Line :
City : MANHATTAN
State : KS
Zip : 66503-7579
Country : US
Telephone Number : 785-564-1800
Fax Number :
Provider Business Practice Location Address
First Line : 1419 WESTPORT LANDING PL
Second Line : STE 103
City : MANHATTAN
State : KS
Zip : 66502-2906
Country : US
Telephone Number : 785-564-1800
Fax Number :
Authorized Official
Title or Position : PHYSICIAN-OWNER
Name : DR. PAUL EUGENE ZACHARY JR.
Credential : MD
Telephone Number : 785-564-1800
Provider Enumeration Date : 10/01/2010
Last Update Date : 10/01/2010

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