Organization
GASTROENTEROLOGY AND LIVER DISEASE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REMI R JAIYEOLA MD (MEMBER/DIRECTOR)
(423) 622-3494
Entity
Organization
Contact information
Practice address
2337 MCCALLIE AVE, SUITE 103, CHATTANOOGA, TN 37404-3257
(423) 622-3494
(423) 622-3495
Mailing address
2337 MCCALLIE AVE, PLAZA ONE, SUITE 103, CHATTANOOGA, TN 37404-3257
(423) 622-3494
(423) 622-3495
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD000040546
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3001310
—
TN
01
—
4185307
BLUE SHIELD OF TN
TN
05
—
714633754B
—
GA
Enumeration date
05/22/2007
Last updated
07/18/2008
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