Healthcare Provider Details

I. General information

NPI: 1508841800
Provider Name (Legal Business Name): ROBERT A GATLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GREEN VALLEY PKWY BLD 3 SUITE B
HENDERSON NV
89074-5885
US

IV. Provider business mailing address

1701 N GREEN VALLEY PKWY BLD 3 SUITE B
HENDERSON NV
89074-5885
US

V. Phone/Fax

Practice location:
  • Phone: 702-737-3200
  • Fax: 702-369-4727
Mailing address:
  • Phone: 702-737-3200
  • Fax: 702-369-4727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3436
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: