Provider Demographics
NPI:1083354377
Name:GATLIN, WILLIAM H (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:GATLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:H
Other - Last Name:GATLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:2813 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2616
Mailing Address - Country:US
Mailing Address - Phone:936-203-8833
Mailing Address - Fax:
Practice Address - Street 1:4611 CAMPUS RIDGE DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-9533
Practice Address - Country:US
Practice Address - Phone:989-839-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-01
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151017056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty