Healthcare Provider Details

I. General information

NPI: 1134053614
Provider Name (Legal Business Name): FERLIN GATLIN SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 E SHOTWELL ST
BAINBRIDGE GA
39819-4388
US

IV. Provider business mailing address

14382 US HIGHWAY 19 S
THOMASVILLE GA
31757-4801
US

V. Phone/Fax

Practice location:
  • Phone: 229-246-7583
  • Fax: 229-246-7585
Mailing address:
  • Phone: 229-228-5545
  • Fax: 229-226-4755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: