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NORTHERN ARIZONA GASTROENTEROLOGY NPI 1417902511


NPI Information

NPI: 1417902511
Provider Name: NORTHERN ARIZONA GASTROENTEROLOGY
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 03D0877519

Address:
77 W FOREST AVE
STE 210
FLAGSTAFF, AZ
ZIP 86001
Phone: (928) 773-2547
Get Directions

NORTHERN ARIZONA GASTROENTEROLOGY is a gastroenterology internal medicine in Flagstaff, 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. NORTHERN ARIZONA GASTROENTEROLOGY NPI is 1417902511. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

77 W FOREST AVE
STE 210
FLAGSTAFF, AZ
ZIP 86001-479
Phone: (928) 773-2547
Fax: (928) 773-2548

The provider's authorized official is Stephanie D Hawthorne .
The authorized official title is President, Northern Arizona Gastroe and has the following contact phone number (928) 773-2547.

The CLIA number assigned to this NPI record is 03D0877519 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2006 and was last updated on 1/15/2013.


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
1WCJCYMEDICARE ID-TYPE UNSPECIFIEDARIZONA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.