Organization
ACCESS GASTROENTEROLGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK DORVILUS MD (PHYISICAN)
(912) 871-3777
Entity
Organization
Contact information
Practice address
1601 FAIR RD SUITE 500, STATESBORO, GA 30438
(912) 871-3777
(912) 871-3677
Mailing address
1601 FAIR RD SUITE 500, STATESBORO, GA 30458
(912) 871-3777
(912) 871-3677
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
060450
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003104036E
—
GA
Enumeration date
08/16/2013
Last updated
10/20/2017
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