Provider Demographics
NPI:1801101100
Name:GATTI, JOSEPH ROCCO (PA-C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ROCCO
Last Name:GATTI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 SISKIYOU BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6462
Mailing Address - Country:US
Mailing Address - Phone:541-200-2777
Mailing Address - Fax:
Practice Address - Street 1:2924 SISKIYOU BLVD
Practice Address - Street 2:STE 200
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6462
Practice Address - Country:US
Practice Address - Phone:541-200-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORPA170782OtherOREGON STATE LICENSE