Provider Demographics
NPI:1144580895
Name:MATTOCKS, ERIN NICHOLE (DO)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICHOLE
Last Name:MATTOCKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4687
Mailing Address - Country:US
Mailing Address - Phone:352-375-1212
Mailing Address - Fax:352-371-4650
Practice Address - Street 1:4645 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4687
Practice Address - Country:US
Practice Address - Phone:352-375-1212
Practice Address - Fax:352-371-4650
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019433207R00000X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology