Organization
GASTROENTEROLOGISTS CONSULTANTS OF JASPER, PC
Active
Other names
GASTROENTEROLOGISTS CONSULTANTS OF JASPER, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS R DAVILA M.D. (PRESIDENT)
(205) 295-9630
Entity
Organization
Contact information
Practice address
3400 HIGHWAY 78 E, MEDICAL ARTS TOWER SUITE 504, JASPER, AL 35501-8907
(205) 295-9630
(205) 296-9362
Mailing address
PO BOX 391, JASPER, AL 35502-0391
(205) 295-9630
(205) 295-9362
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25227
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051553611DAV
—
AL
01
—
515-15424
BSBC
AL
Enumeration date
04/01/2007
Last updated
11/19/2014
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