Organization
GASTROENTEROLOGY OF TYLER, P.A.
Active
Organization
GASTROENTEROLOGY OF TYLER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN A HUTTO M.D. (GASTROENTEROLOGIST)
(903) 597-0202
Entity
Organization
Contact information
Practice address
700 OLYMPIC PLAZA CIR, SUITE 410, TYLER, TX 75701-1951
(903) 597-0202
(903) 597-0231
Mailing address
700 OLYMPIC PLAZA CIR, SUITE 410, TYLER, TX 75701-1951
(903) 597-0202
(903) 597-0231
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013JE
BLUECROSS & BLUESHIELD
TX
01
—
100016832
RAILROAD MEDICARE
TX
05
—
152564401
—
TX
Enumeration date
12/04/2007
Last updated
11/17/2011
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