Active NPI
Gastroenterology Associates of Dublin LLC
- Gastroenterology Physician
- Dublin, GA
National Provider Identifier
1629441613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 048883
- Legal business name
- GASTROENTEROLOGY ASSOCIATES OF DUBLIN LLC
- Practice address
- 104 Fairview Park Dr
Dublin, GA 31021-2500 - Phone
- (478) 277-1255
- Fax
- (478) 304-1467
- NPI assigned
- Nov 12, 2015
- Organization subpart
- Yes
- Parent organization
- SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tony M O'Steen
- Title
- Cfo VP Finance
- Phone
- (912) 538-5314
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 048883 | GA | Primary |
Addresses
Primary practice location
104 Fairview Park Dr
Dublin, GA 31021-2500
Mailing address
PO Box 1528
Dublin, GA 31040-1528
Phone (478) 272-1366
National Provider Directory
National Provider Directory- Part of
- Southeast Regional Primary Care Corporation
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447286400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1596758400000",
"number": "1629441613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1528",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310401528",
"telephone_number": "478-272-1366",
"fax_number": "478-277-1251"
},
{
"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": "GASTROENTEROLOGY ASSOCIATES OF DUBLIN LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTHEAST REGIONAL PRIMARY CARE CORPORATION",
"enumeration_date": "2015-11-12",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A",
"authorized_official_last_name": "O'STEEN",
"authorized_official_first_name": "TONY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CFO VP FINANCE",
"authorized_official_telephone_number": "912-538-5314"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "GA",
"license": "048883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.