Provider Demographics
NPI:1801498506
Name:GATZMAN, DOUGLAS B III (RN-BSN)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:B
Last Name:GATZMAN
Suffix:III
Gender:M
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 NW 33RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-7250
Mailing Address - Country:US
Mailing Address - Phone:918-869-5421
Mailing Address - Fax:
Practice Address - Street 1:1013 NW 33RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-7250
Practice Address - Country:US
Practice Address - Phone:918-869-5421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator