Sandusky Gastroenterologists, Inc.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

034991 Issued in OH

Legal business name

SANDUSKY GASTROENTEROLOGISTS, INC.

Practice address

1410 Milan Rd
Sandusky, OH 44870-4130

Phone

(419) 627-1056

Fax

(419) 627-6269

NPI assigned

Sep 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lawrence R. McCormack, M.D.

Title

President

Phone

(419) 627-1056

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1003002270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 MILAN RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704130",
            "telephone_number": "419-627-1056",
            "fax_number": "419-627-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 MILAN RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704130",
            "telephone_number": "419-627-1056",
            "fax_number": "419-627-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDUSKY GASTROENTEROLOGISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "MCCORMACK",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-627-1056",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "034991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361791",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Sandusky, OH
• Providers in Sandusky, OH by specialty
• Gastroenterology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.