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DEKALB GASTROENTEROLOGY ASSOCIATES NPI 1508985425


NPI Information

NPI: 1508985425
Provider Name: DEKALB GASTROENTEROLOGY ASSOCIATES
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 11D0720150

Address:
2675 N DECATUR RD
SUITE 506
DECATUR, GA
ZIP 30033
Phone: (404) 299-1679
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DEKALB GASTROENTEROLOGY ASSOCIATES is a gastroenterology internal medicine in Decatur, GA. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. DEKALB GASTROENTEROLOGY ASSOCIATES NPI is 1508985425. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2675 N DECATUR RD
SUITE 506
DECATUR, GA
ZIP 30033-131
Phone: (404) 299-1679
Fax: (404) 508-7694

The provider's authorized official is Brenda Cohilas .
The authorized official title is Practice Manager and has the following contact phone number (404) 508-7676.

The CLIA number assigned to this NPI record is 11D0720150 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2007 and was last updated on 7/18/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0100XInternal MedicineGastroenterologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERGEORGIATAX ID
2GRP3002MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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