Organization Active NPI

Digestive Associates, Inc.

  • Gastroenterology Physician
  • Brunswick, GA
National Provider Identifier
1730221409
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
DIGESTIVE ASSOCIATES, INC.
Practice address
3217 4TH St
Brunswick, GA 31520-3759
Phone
(912) 267-0058
Fax
(912) 267-0061
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Huitt E Mattox III, M.D.
Title
Managing Member
Phone
(912) 267-0058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

3217 4TH St
Brunswick, GA 31520-3759

Mailing address

3217 4TH St
Brunswick, GA 31520-3759
Phone (912) 267-0058

Other identifiers 1

IdentifierTypeStateIssuer
300023313AMedicaidGA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1730221409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 4TH ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203759",
            "telephone_number": "912-267-0058",
            "fax_number": "912-267-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 4TH ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203759",
            "telephone_number": "912-267-0058",
            "fax_number": "912-267-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "MATTOX",
        "authorized_official_first_name": "HUITT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "912-267-0058",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "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": "300023313A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.