Provider Demographics
NPI:1306463658
Name:OAKLEY, GAVIN WILIAM (DPM)
Entity type:Individual
Prefix:DR
First Name:GAVIN
Middle Name:WILIAM
Last Name:OAKLEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10865 BOYETTE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-8012
Mailing Address - Country:US
Mailing Address - Phone:813-540-1160
Mailing Address - Fax:813-742-4259
Practice Address - Street 1:10865 BOYETTE RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-8012
Practice Address - Country:US
Practice Address - Phone:813-540-1160
Practice Address - Fax:813-742-4259
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4482213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery