Organization
CENTER FOR DIGESTIVE DISEASES PA
Active
Organization
CENTER FOR DIGESTIVE DISEASES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY F JACKSON (SCHEDULE COORNIDATOR)
(727) 384-2016
Entity
Organization
Contact information
Practice address
1609 PASADENA AVE S, STE 3M, ST PETERSBURG, FL 33707-4563
(727) 384-2016
(727) 343-3791
Mailing address
PO BOX 20267, TAMPA, FL 33622-0267
(727) 823-2188
(727) 828-0723
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME48637
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24038
BCBS
FL
05
—
373745400
—
FL
01
—
CL1357
RAILROAD MEDICARE
FL
Enumeration date
07/08/2006
Last updated
06/18/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up