Gi Associates Of Big Bend Llc | |
2457 Care Dr Ste D100 Tallahassee FL 32308-3500 | |
(850) 841-1166 | |
Not Available |
Full Name | Gi Associates Of Big Bend Llc |
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Speciality | Internal Medicine |
Location | 2457 Care Dr Ste D100, Tallahassee, Florida |
Authorized Official Name and Position | Dale W Polley (PRESIDENT) |
Authorized Official Contact | 6153456900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gi Associates Of Big Bend Llc 401 Commerce St Ste 600 Nashville TN 37219-2518 Ph: (615) 345-6900 | Gi Associates Of Big Bend Llc 2457 Care Dr Ste D100 Tallahassee FL 32308-3500 Ph: (850) 841-1166 |
NPI Number | 1710417191 |
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Provider Enumeration Date | 06/18/2017 |
Last Update Date | 06/18/2017 |
Medicare PECOS PAC ID | 4587930995 |
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Medicare Enrollment ID | O20171030000864 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710417191 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Frances Ruth Vitalis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356446116 PECOS PAC ID: 5193793651 Enrollment ID: I20040922000465 |
Provider Name | Lorie Simmons |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992723225 PECOS PAC ID: 0941202824 Enrollment ID: I20070206000204 |
Provider Name | Joseph L Webster |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1508896135 PECOS PAC ID: 6901719624 Enrollment ID: I20071129000715 |
Provider Name | Leonard S Leichus |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1871596148 PECOS PAC ID: 7113811811 Enrollment ID: I20080216000005 |
Provider Name | Robert M Finlaw |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1093744310 PECOS PAC ID: 8729273669 Enrollment ID: I20110506000220 |
Provider Name | David L Beall |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225569965 PECOS PAC ID: 2365716677 Enrollment ID: I20170926002459 |
Provider Name | Robert S Glickenberger |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1407966690 PECOS PAC ID: 6507999554 Enrollment ID: I20180731000115 |
Provider Name | Nicholas V Costrini |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1063444636 PECOS PAC ID: 2466627302 Enrollment ID: I20190321001179 |
Provider Name | Elizabeth A Whelan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437795812 PECOS PAC ID: 7416348461 Enrollment ID: I20211229001815 |
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