Organization
TENNESSEE VALLEY GASTROENTEROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON WILKES M.D. (OWNER/PHYSICIAN)
(256) 766-8667
Entity
Organization
Contact information
Practice address
416 N. SEMINARY STREET, STE 3100, FLORENCE, AL 35630
(256) 766-8667
(256) 767-5327
Mailing address
416 N. SEMINARY STREET, SUITE 3100, FLORENCE, AL 35630
(256) 766-8667
(256) 767-5327
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
00006975
AL
207RG0100X
Gastroenterology Physician
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051521216
—
AL
05
—
529919960
—
AL
Enumeration date
01/30/2007
Last updated
05/09/2017
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