FAYETTEVILLE GASTROENTEROLOGY ASSOCIATES, P.A.
Ambulatory Health at Valleygate Dr, Fayetteville, NC

License number
North Carolina AS0071
Category
Ambulatory Health
Type
Endoscopy
Owner
Name: MRS. TINA M. CASILLO
Title: PRACTICE ADMINISTRATOR
Phone: (910) 323-5203
Address
Address
2041 Valleygate Dr, Fayetteville, NC 28304
National Provider ID: 1417141623
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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FAYETTEVILLE GASTROENTEROLOGY ASSOCIATES, PA

Fayetteville, NC

Doing business as:
SOUTHEASTERN GASTROENTEROLOGY ASSOCIATES, PA
Registration:
Apr 18, 1995
Phone:
(910) 323-5203 (Phone)
Addresses:
1738 Metromedical Dr, Fayetteville, NC 28304 (Physical)
PO Box 1239, Fayetteville, NC 28304 (Mailing)
PO Box 87229, Fayetteville, NC 28304
State ID:
0366989
Agent:
John Richard Jones
Categories:
Physicians & Surgeons-Gastroenterology

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