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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