Provider Demographics
NPI:1700048592
Name:ROBERT A GATLIN MD CHTD
Entity Type:Organization
Organization Name:ROBERT A GATLIN MD CHTD
Other - Org Name:NEVADA WOMENS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:GATLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-737-3200
Mailing Address - Street 1:1701 N GREEN VALLEY PKWY
Mailing Address - Street 2:STE 3B
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5885
Mailing Address - Country:US
Mailing Address - Phone:702-737-3200
Mailing Address - Fax:702-369-4727
Practice Address - Street 1:1701 N GREEN VALLEY PKWY
Practice Address - Street 2:STE 3B
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5885
Practice Address - Country:US
Practice Address - Phone:702-737-3200
Practice Address - Fax:702-369-4727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3436207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVC96062Medicare UPIN
NVVWCHJQMedicare PIN