Organization
TRI-STATE GASTROENTEROLOGY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY S MCCORD MD (PHYSICIAN)
(812) 842-2701
Entity
Organization
Contact information
Practice address
4133 GATEWAY BLVD, SUITE 290, NEWBURGH, IN 47630-7953
(812) 842-2701
(812) 842-2717
Mailing address
PO BOX 5068, EVANSVILLE, IN 47716-5068
(812) 842-2701
(812) 842-2717
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01038295
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042589
ANTHEM
—
01
—
100002411
RAILROAD MEDICARE
—
05
—
100180010A
—
IN
05
—
200073540A
—
IN
05
—
400746743
—
IL
05
—
64871676
—
KY
Enumeration date
06/02/2006
Last updated
04/15/2014
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