| Gastroenterologists Consultants Of Jasper, Pc | |
|
3400 Highway 78 E Medical Arts Tower Suite 504 Jasper AL 35501-8907 | |
| (205) 295-9630 | |
| (205) 296-9362 |
| Full Name | Gastroenterologists Consultants Of Jasper, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3400 Highway 78 E, Jasper, Alabama |
| Authorized Official Name and Position | Luis R Davila (PRESIDENT) |
| Authorized Official Contact | 2052959630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterologists Consultants Of Jasper, Pc Po Box 391 Jasper AL 35502-0391 Ph: (205) 295-9630 | Gastroenterologists Consultants Of Jasper, Pc 3400 Highway 78 E Medical Arts Tower Suite 504 Jasper AL 35501-8907 Ph: (205) 295-9630 |
| NPI Number | 1053431924 |
|---|---|
| Provider Enumeration Date | 04/01/2007 |
| Last Update Date | 11/19/2014 |
| Medicare PECOS PAC ID | 2365696978 |
|---|---|
| Medicare Enrollment ID | O20130207000299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053431924 | NPI | - | NPPES |
| 051553611DAV | Medicaid | AL | |
| 515-15424 | Other | AL | BSBC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 25227 (Alabama) | Primary |
| Provider Name | Luis R Davila |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861616153 PECOS PAC ID: 9133114523 Enrollment ID: I20040415001140 |
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