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ALPHARETTA GASTROENTEROLOGY ASSOC. P.C. NPI 1215106190


NPI Information

NPI: 1215106190
Provider Name: ALPHARETTA GASTROENTEROLOGY ASSOC., P.C.
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 11D1021772

Address:
11660 ALPHARETTA HWY
SUITE 420
ROSWELL, GA
ZIP 30076
Phone: (770) 442-5882
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ALPHARETTA GASTROENTEROLOGY ASSOC., P.C. is a specialist in Roswell, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ALPHARETTA GASTROENTEROLOGY ASSOC., P.C. NPI is 1215106190. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11660 ALPHARETTA HWY
SUITE 420
ROSWELL, GA
ZIP 30076-943
Phone: (770) 442-5882
Fax: (770) 664-6134

The provider's authorized official is Meredith Thomas Riddick .
The authorized official title is President and has the following contact phone number (770) 442-5882.

The CLIA number assigned to this NPI record is 11D1021772 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/26/2008 and was last updated on 2/26/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist022269GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D30612MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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