Organization
GASTROENTEROLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERLING LARSON III M.D. (MEDICAL DIRECTOR)
(563) 383-2686
Entity
Organization
Contact information
Practice address
2222 53RD AVENUE, BETTENDORF, IA 52753
(563) 383-2686
(563) 884-8144
Mailing address
2222 53RD AVENUE, BETTENDORF, IA 52753
(563) 383-2686
(563) 884-8144
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0455097
—
IA
01
—
71951
MEDICARE GROUP #
IA
Enumeration date
07/11/2006
Last updated
07/17/2008
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