=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720512569
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GATELEY PODIATRY, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2017
-----------------------------------------------------
Last Update Date | 04/20/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6730 SW MISSION VIEW DR
-----------------------------------------------------
City | TOPEKA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66614-5652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-730-3478
-----------------------------------------------------
Fax | 785-783-8983
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6021 SW 29TH ST STE A BOX 352
-----------------------------------------------------
City | TOPEKA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66614-6201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | TIMOTHY B GATELEY
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 785-250-4391
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0131X
-----------------------------------------------------
Taxonomy Name | Foot Surgery Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------