Healthcare Provider Details

I. General information

NPI: 1366776445
Provider Name (Legal Business Name): JOSHUA F GASTLEY NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 N MAIN ST
MAYSVILLE GA
30558-1702
US

IV. Provider business mailing address

154 WEST TUGALO STREET
TOCCOA GA
30577-2360
US

V. Phone/Fax

Practice location:
  • Phone: 706-652-2252
  • Fax: 706-652-3444
Mailing address:
  • Phone: 706-886-1309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number154209
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number154209
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: