Provider Demographics
NPI:1598392664
Name:GASTALDO, NATHANIEL J (DPM)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:J
Last Name:GASTALDO
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-688-1330
Mailing Address - Fax:270-688-1338
Practice Address - Street 1:910 WALLACE AVE STE 301
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-2418
Practice Address - Country:US
Practice Address - Phone:270-200-4545
Practice Address - Fax:270-200-4543
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2023-08-11
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Provider Licenses
StateLicense IDTaxonomies
KY282971213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery