NPI 1104835461

Premier Gastroenterology, P. C.

Organisation Specialist Southaven, MS

Practice location

Address: 7900 Airways Blvd Bldg a STE 3a, Southaven, MS 38671-4113
Phone: (662) 349-6113
Fax: (662) 349-6188
Mailing address: PO Box 40895, Memphis, TN 38174-0895

Authorised official

Name: Tariq A. Khan
Title: President
Phone: (662) 349-6113

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

Other Specialist providers in Mississippi →

Registry record

NPI: 1104835461
Entity type: Organization
NPI issued: 5 Aug 2006
Record last updated: 7 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.