Organization
CAPITAL CITY GASTROENTEROLOGY, PC
Active
Organization
CAPITAL CITY GASTROENTEROLOGY, PC
Active
Other names
Capital City Gatsroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANDI BUTLER (ADMINISTRATOR)
(334) 239-9257
Entity
Organization
Contact information
Practice address
4126 CARMICHAEL CT, MONTGOMERY, AL 36106-2871
(334) 495-2600
(334) 495-2604
Mailing address
4126 CARMICHAEL CT, MONTGOMERY, AL 36106-2871
(334) 495-2600
(334) 495-2604
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01D1026965
CLIA WAIVER
—
Enumeration date
02/13/2006
Last updated
08/09/2019
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