Provider Demographics
NPI:1073802245
Name:GADLIN, KASSANDRA RATOWSKY (MD)
Entity Type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:RATOWSKY
Last Name:GADLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 BAXTER ST
Mailing Address - Street 2:P.O. BOX 7127
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3712
Mailing Address - Country:US
Mailing Address - Phone:706-227-3450
Mailing Address - Fax:
Practice Address - Street 1:1230 BAXTER ST
Practice Address - Street 2:POST OFFICE BOX 7127
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30604
Practice Address - Country:US
Practice Address - Phone:706-227-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005290207L00000X
SC35979207L00000X
GA73896207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology