Provider Demographics
NPI:1164916680
Name:GATTS, JORIE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:JORIE
Middle Name:ELIZABETH
Last Name:GATTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JORIE
Other - Middle Name:ELIZABETH
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3333 BURNET AVE RM T12260AC
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-803-4738
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE RM T12260AC
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3039
Practice Address - Country:US
Practice Address - Phone:513-803-4738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.141964208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program