Basic Information
| Provider Information | |||||||||
| NPI: | 1306083936 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAZA | ||||||||
| FirstName: | GOPAL | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 RICE MINE RD N | ||||||||
| Address2: | SUITE E | ||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354060839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053450010 | ||||||||
| FaxNumber: | 2057521175 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 RICE MINE RD N | ||||||||
| Address2: | SUITE E | ||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354060839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053450010 | ||||||||
| FaxNumber: | 2057521175 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2009 | ||||||||
| LastUpdateDate: | 03/23/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD.33843 | AL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | MD.33843 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.