Provider Demographics
NPI:1790026235
Name:GATES, TIMOTHY EUGENE (TDH)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:EUGENE
Last Name:GATES
Suffix:
Gender:M
Credentials:TDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 DEEP CREEK RD NW
Mailing Address - Street 2:
Mailing Address - City:DEWY ROSE
Mailing Address - State:GA
Mailing Address - Zip Code:30634-3006
Mailing Address - Country:US
Mailing Address - Phone:404-859-7342
Mailing Address - Fax:
Practice Address - Street 1:2072 DEEP CREEK RD NW
Practice Address - Street 2:
Practice Address - City:DEWY ROSE
Practice Address - State:GA
Practice Address - Zip Code:30634-3006
Practice Address - Country:US
Practice Address - Phone:404-859-7342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath