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General NPI Number Information
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NPI Number | 1366602005
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Entity Type | Individual
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Provider Name | GATHLINE ETIENNE MD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 2500 HOSPITAL BLVD STE 440
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City | ROSWELL
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State | GA
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Zip | 30076-4919
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Country | US
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Telephone | 770-663-4649
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Fax | 770-663-3930
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Provider Business Mailing Address
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Address Line | 2500 HOSPITAL BLVD STE 440
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City | ROSWELL
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State | GA
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Zip | 30076-4919
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Country | US
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Telephone | 770-663-4649
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Fax | 770-663-3930
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 070551
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME107645
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036173876
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License Number State | IL
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