Premier Gastroenterology, P. C.

NPI #1104835461 in Southaven, Mississippi

Provider Information

NPI Number: 1104835461
Entity Type: Organization
Organization Name: Premier Gastroenterology, P. C.
Primary Specialty: Specialist
Enumeration Date: Aug 5, 2006
Last Updated: May 7, 2008

Practice Location

Address: 7900 AIRWAYS BLVD
Address 2: BLDG A STE 3A
City: Southaven
State: Mississippi
ZIP Code: 38671-4113
Phone: (662) 349-6113

Authorized Official

Name: TARIQ A. KHAN, M.D.
Title: PRESIDENT
Phone: (662) 349-6113

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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