Organization
MERIDIAN GASTROENTEROLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT CRAIG DUNGAN M.D. (OWNER)
(601) 703-9165
Entity
Organization
Contact information
Practice address
1800 12TH ST, SUITE 1D, MERIDIAN, MS 39301-4158
(601) 703-9165
(601) 703-9483
Mailing address
PO BOX 1769, MERIDIAN, MS 39302-1769
(601) 703-9506
(601) 703-3264
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA7569
RAILROAD MEDICARE
—
Enumeration date
05/03/2006
Last updated
08/22/2020
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