Organization
GASTROENTEROLOGY CENTER OF THE MIDSOUTH PLLC
Active
Other names
Midstate Gastroenterology, Associates In Gastroenterology, Gastroenterology Associates of North Mississippi, Digestive Health Specialists, Gastro One, Skyline Gastroenterology of West Tennessee
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MATERNA (DIRECTOR, CREDENTIALING)
(901) 377-8219
Entity
Organization
Contact information
Practice address
8000 WOLF RIVER BLVD STE 200, GERMANTOWN, TN 38138-1755
(901) 747-3630
Mailing address
ONE GI CREDENTIALING DEPARTMENT, PO BOX 381468, GERMANTOWN, TN 38183-1468
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
12/13/2005
Last updated
02/03/2026
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