How can i find/determine the best gastroenterologist in a state so small that most doctors don't have ratings on healthtap or healthgrades?

PCP: Neither of those rankings determine whose the best in their field. Health tap is a game for doctors and visitors, as stated on their website. Health grades is not recognized by any medical specialty as a legitimate rating site because anyone (including the doctor him or herself) can rate themselves. Try the specialty organization: http://m.Gi.Org/ or http://m.Gastro.Org/. Hope that helped.