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GASTROENTEROLOGY ASSOCIATES OF SOUTHEAST MO PC NPI 1720035439


NPI Information

NPI: 1720035439
Provider Name: GASTROENTEROLOGY ASSOCIATES OF SOUTHEAST MO, PC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 26D0940214

Address:
1429 N MOUNT AUBURN RD
CAPE GIRARDEAU, MO
ZIP 63701
Phone: (573) 334-8870
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GASTROENTEROLOGY ASSOCIATES OF SOUTHEAST MO, PC is a gastroenterology internal medicine in Cape Girardeau, MO. 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. GASTROENTEROLOGY ASSOCIATES OF SOUTHEAST MO, PC NPI is 1720035439. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1429 N MOUNT AUBURN RD
CAPE GIRARDEAU, MO
ZIP 63701-171
Phone: (573) 334-8870
Fax: (573) 334-7340

The provider's authorized official is Robyn Crocetti .
The authorized official title is Administrator and has the following contact phone number (573) 334-8870.

The CLIA number assigned to this NPI record is 26D0940214 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/28/2006 and was last updated on 6/9/2008.


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 MedicineGastroenterologyMISSOURIYes

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
1000011310MEDICARE ID-TYPE UNSPECIFIEDMISSOURI
2502633506MEDICAIDMISSOURI

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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