Provider Demographics
NPI:1669491536
Name:CATLIN, LIONEL B (MD)
Entity Type:Individual
Prefix:DR
First Name:LIONEL
Middle Name:B
Last Name:CATLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1581 HIGHWAY 98 W
Mailing Address - Street 2:
Mailing Address - City:CARRABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:32322-5009
Mailing Address - Country:US
Mailing Address - Phone:850-697-3420
Mailing Address - Fax:850-697-3423
Practice Address - Street 1:1581 HIGHWAY 98 W
Practice Address - Street 2:
Practice Address - City:CARRABELLE
Practice Address - State:FL
Practice Address - Zip Code:32323
Practice Address - Country:US
Practice Address - Phone:850-697-3420
Practice Address - Fax:850-697-3423
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN212207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275192500Medicaid
FLU8416ZMedicare ID - Type Unspecified
FL275192500Medicaid
FL101949Medicare Oscar/Certification