Provider Demographics
NPI:1316921240
Name:GATTI, ANTHONY J (DPM)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:GATTI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:792 CHURCH ST
Mailing Address - Street 2:STE 101
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060
Mailing Address - Country:US
Mailing Address - Phone:770-422-9856
Mailing Address - Fax:770-984-0303
Practice Address - Street 1:792 CHURCH ST
Practice Address - Street 2:STE 101
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060
Practice Address - Country:US
Practice Address - Phone:770-422-9856
Practice Address - Fax:770-984-0303
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000406213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00005871BMedicaid
GA0575822OtherAETNA
GA702031OtherBC
GA00005871BMedicaid