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Organization
ENDOSCOPY GROUP LLC
Active
Organization
ENDOSCOPY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN DUNN (ADMINISTRATOR/CFO)
(850) 474-8988
Entity
Organization
Contact information
Practice address
4810 N DAVIS HWY, PENSACOLA, FL 32503-2341
(850) 474-8988
(850) 478-9903
Mailing address
4810 N DAVIS HWY, PENSACOLA, FL 32503-2341
(850) 477-8109
(850) 478-9903
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079204700
—
FL
01
—
3804534
CIGNA
—
01
—
490003997
RAILROAD MEDICARE
—
01
—
5121097
AETNA
—
01
—
65B
HEALTH OPTIONS
—
01
—
987585
USA HEALTH NETWORK
—
Enumeration date
02/08/2006
Last updated
03/01/2018
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