Organization
GASTROENTEROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK BARTLEY CPA (CHIEF ADMINISTRATIVE OFFICER)
(423) 246-6777
Entity
Organization
Contact information
Practice address
135 W RAVINE RD, SUITE 3A, KINGSPORT, TN 37660-3847
(423) 246-6777
(423) 246-7766
Mailing address
135 W RAVINE RD, SUITE 3A, KINGSPORT, TN 37660-3847
(423) 246-6777
(423) 246-7766
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
207RG0100X
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3700033
—
TN
01
—
88305
BCBS GROUP
TN
Enumeration date
09/12/2005
Last updated
05/04/2009
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