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Organization
GASTROINTESTINAL SPECIALISTS FOUNDATION, INC
Active
Organization
GASTROINTESTINAL SPECIALISTS FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY M DUCKETT (SR VP/CLO)
(901) 227-5233
Entity
Organization
Contact information
Practice address
80 HUMPHREYS CENTER DR STE 200, MEMPHIS, TN 38120-2352
(901) 578-2538
(901) 578-2572
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5800
(901) 578-2538
(901) 578-2572
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
—
AR
207RG0100X
Gastroenterology Physician
Primary
—
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
TN
363LF0000X
Family Nurse Practitioner
—
TN
367500000X
Certified Registered Nurse Anesthetist
—
TN
Other
Enumeration date
01/02/2013
Last updated
12/16/2019
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