Dublin Gastroenterology Assoc, LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

DUBLIN GASTROENTEROLOGY ASSOC, LLC

Practice address

104 Fairview Park Dr
Dublin, GA 31021-2500

Phone

(478) 277-1255

Fax

(478) 304-1467

NPI assigned

Apr 30, 2010

Last updated

Dec 4, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ellen K Barr

Title

Administrator

Phone

(478) 272-1366

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449187200000",
    "number": "1477870327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1925",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310401925",
            "telephone_number": "478-277-1255",
            "fax_number": "478-304-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FAIRVIEW PARK DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212500",
            "telephone_number": "478-277-1255",
            "fax_number": "478-304-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBLIN GASTROENTEROLOGY ASSOC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-30",
        "last_updated": "2015-12-04",
        "status": "A",
        "authorized_official_last_name": "BARR",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "478-272-1366"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003109888A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Dublin, GA
• Providers in Dublin, GA by specialty
• Gastroenterology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; 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.