| Gastroenterology Physician Services Llc | |
|
2200 Hamilton Rd Columbus GA 31904-8855 | |
| (706) 655-8800 | |
| (706) 940-4764 |
| Full Name | Gastroenterology Physician Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2200 Hamilton Rd, Columbus, Georgia |
| Authorized Official Name and Position | Shane B Darrah (CEO) |
| Authorized Official Contact | 7062434500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Physician Services Llc Po Box 8629 Columbus GA 31908-8629 Ph: (706) 655-8800 | Gastroenterology Physician Services Llc 2200 Hamilton Rd Columbus GA 31904-8855 Ph: (706) 655-8800 |
| NPI Number | 1750025425 |
|---|---|
| Provider Enumeration Date | 04/27/2022 |
| Last Update Date | 06/06/2022 |
| Medicare PECOS PAC ID | 7315325974 |
|---|---|
| Medicare Enrollment ID | O20220609003022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750025425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| 2080P0206X | Pediatrics - Pediatric Gastroenterology | (* (Not Available)) | Secondary |
| Provider Name | Daniel L Schoenborn |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326252503 PECOS PAC ID: 6507040847 Enrollment ID: I20110411000320 |
| Provider Name | Humberto Jose Rios |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316439987 PECOS PAC ID: 5092135566 Enrollment ID: I20230925000271 |
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