| Premier Gastroenterology | |
|
3930 Mezzanine Dr Suite D Lafayette IN 47905-8646 | |
| (765) 807-2787 | |
| (765) 807-7989 |
| Full Name | Premier Gastroenterology |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 3930 Mezzanine Dr, Lafayette, Indiana |
| Authorized Official Name and Position | Martha K Miller (DIRECTOR OF BILLING) |
| Authorized Official Contact | 7654465286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Gastroenterology Po Box 4699 Lafayette IN 47903-4699 Ph: (765) 449-2732 | Premier Gastroenterology 3930 Mezzanine Dr Suite D Lafayette IN 47905-8646 Ph: (765) 807-2787 |
| NPI Number | 1265773402 |
|---|---|
| Provider Enumeration Date | 03/13/2013 |
| Last Update Date | 07/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265773402 | NPI | - | NPPES |
| 201152580 A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (Indiana) | Primary |
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