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PRESCOTT GASTROENTEROLOGY NPI 1720110984


NPI Information

NPI: 1720110984
Provider Name: PRESCOTT GASTROENTEROLOGY

Other Name: PRESCOTT GASTROENTEROLOGY CONSULTANTS MEDICAL GROUP

Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

Address:
811 AINSWORTH DR STE 103
PRESCOTT, AZ
ZIP 86301
Phone: (928) 771-5548
Get Directions

PRESCOTT GASTROENTEROLOGY is a gastroenterology internal medicine in Prescott, AZ. 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. PRESCOTT GASTROENTEROLOGY NPI is 1720110984. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Prescott Gastroenterology Consultants Medical Group.

The provider's business location address is:

811 AINSWORTH DR STE 103
PRESCOTT, AZ
ZIP 86301-687
Phone: (928) 771-5548
Fax: (928) 771-5549

The provider's authorized official is Debbie Marie De Luna .
The authorized official title is Office Manager and has the following contact phone number (928) 771-5548.

The enumeration date for this NPI number is 3/12/2007 and was last updated on 8/27/2010.


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 MedicineGastroenterology22747ARIZONAYes

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
1176950MEDICAIDARIZONA
2Z100903MEDICARE PINARIZONA

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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