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NORTHSIDE GASTROENTEROLOGY INC. PC NPI 1568578201


NPI Information

NPI: 1568578201
Provider Name: NORTHSIDE GASTROENTEROLOGY, INC., PC

Former Legal Business Name: NORTHSIDE GASTROENTEROLOGY

Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 15D2163915

Address:
8424 NAAB RD
SUITE 3-J
INDIANAPOLIS, IN
ZIP 46260
Phone: (317) 872-7396
Get Directions

NORTHSIDE GASTROENTEROLOGY, INC., PC is a gastroenterology internal medicine in Indianapolis, IN. 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. NORTHSIDE GASTROENTEROLOGY, INC., PC NPI is 1568578201. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Northside Gastroenterology.

The provider's business location address is:

8424 NAAB RD
SUITE 3-J
INDIANAPOLIS, IN
ZIP 46260
Phone: (317) 872-7396
Fax: (317) 879-8328

The provider's authorized official is Galinton Bryan .
The authorized official title is Practice Admin and has the following contact phone number (317) 872-7396.

The CLIA number assigned to this NPI record is 15D2163915 - other - read only pathology labor with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 2/8/2019.


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
1207ZP0102XPathologyAnatomic Pathology & Clinical PathologyNo
2207RG0100XInternal 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
1100177420MEDICAIDINDIANA

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: 4/28/2024

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