Organization
GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIERCE D. DOTHEROW M.D. (AUTHORIZED OFFICIAL)
(601) 355-1234
Entity
Organization
Contact information
Practice address
2510 LAKELAND DR, FLOWOOD, MS 39232-9513
(601) 355-1234
(601) 326-3566
Mailing address
2510 LAKELAND DR, FLOWOOD, MS 39232-9513
(601) 355-1234
(601) 326-3566
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
25C0001033
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770495
—
MS
Enumeration date
04/06/2007
Last updated
12/06/2016
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