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SOUTHERN GASTROENTEROLOGY& HEPATOLOGY CONSULTANTS INC NPI 1336320761


NPI Information

NPI: 1336320761
Provider Name: SOUTHERN GASTROENTEROLOGY& HEPATOLOGY CONSULTANTS INC
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 11D0961485

Address:
300 SHIRLEY AVE
DOUGLAS, GA
ZIP 31533
Phone: (912) 384-7275
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SOUTHERN GASTROENTEROLOGY& HEPATOLOGY CONSULTANTS INC is a gastroenterology internal medicine in Douglas, GA. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. SOUTHERN GASTROENTEROLOGY& HEPATOLOGY CONSULTANTS INC NPI is 1336320761. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

300 SHIRLEY AVE
DOUGLAS, GA
ZIP 31533-332
Phone: (912) 384-7275

The provider's authorized official is Sudhakar Jonnalagadda .
The authorized official title is Officer and has the following contact phone number (912) 384-7275.

The CLIA number assigned to this NPI record is 11D0961485 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2007 and was last updated on 12/8/2010.


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
1207RG0100XInternal MedicineGastroenterologyGA041589GEORGIAYes

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
110BBCDXOTHERGEORGIAMEDICARE

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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