MEDICARE: DR. ROBERT DAVID GATLIFF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	064035	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992786818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT DAVID GATLIFF MD

Provider Business Mailing Address
First Line	:	528 WASHINGTON AVE
Second Line	:
City	:	SANDERSVILLE
State	:	GA
Zip	:	31082-1971
Country	:	US
Telephone Number	:	478-240-2070
Fax Number	:	478-370-2501

Provider Business Practice Location Address
First Line	:	528 WASHINGTON AVE
Second Line	:
City	:	SANDERSVILLE
State	:	GA
Zip	:	31082-1971
Country	:	US
Telephone Number	:	478-240-2070
Fax Number	:	478-370-2501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	09/18/2023

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