Provider Demographics
NPI:1427008192
Name:GATLIN, AMY T (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:T
Last Name:GATLIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-4424
Mailing Address - Country:US
Mailing Address - Phone:252-638-8121
Mailing Address - Fax:252-633-3401
Practice Address - Street 1:2404 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-4424
Practice Address - Country:US
Practice Address - Phone:252-638-8121
Practice Address - Fax:252-633-3401
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890837NMedicaid
NC890837NMedicaid
NC2453459AMedicare PIN