Daniel L Gatlin (NPI# 1124074414, PAC ID# 6406809219) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
Nation Provider ID (NPI) | 1124074414 |
PAC ID by PECOS | 6406809219 |
Professional Enrollment ID | I20050222000046 |
Full Name | Daniel L Gatlin |
Organization Legal Name | PARK NICOLLET CLINIC |
Address |
1415 Saint Francis Ave Shakopee MN 55379-3374 |
Phone Number | 9529937750 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF MINNESOTA MEDICAL SCHOOL |
Graduation Year | 2000 |
Primary Specialty | GENERAL SURGERY |
Group Practice PAC ID | 7911819438 |
Number of Group Practice Members | 1323 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
240104 | ST FRANCIS REGIONAL MEDICAL CENTER |
240053 | PARK NICOLLET METHODIST HOSPITAL |
Address | Phone | Organization |
---|---|---|
5320 Hyland Greens Dr, Bloomington, MN 55437-3934 | 9529932400 | PARK NICOLLET CLINIC |
1415 Saint Francis Ave, Shakopee, MN 55379-3374 | 9529937750 | PARK NICOLLET CLINIC |
1515 Saint Francis Ave, Shakopee, MN 55379-3387 | 9529937750 | PARK NICOLLET CLINIC |
3525 Monterey Dr, St Louis Park, MN 55416-5275 | 9529931990 | PARK NICOLLET CLINIC |
Organization Legal Name | PARK NICOLLET CLINIC |
Physicians | 1272 |
Name | Specialty | Organization | Address |
---|---|---|---|
Grace Marie Irish | Nurse Practitioner | Park Nicollet Clinic | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 |
Johanna Dijkstal Beebe | Ophthalmology | Park Nicollet Clinic | 250 Central Ave N, Wayzata, MN 55391-1206 |
Lonzale Ramsey | Family Medicine | Park Nicollet Clinic | 2001 Blaisdell Ave, Minneapolis, MN 55404-2414 |
Kurt Wolff | Physical Therapy | Park Nicollet Clinic | 15800 N 95th Ave, Maple Grove, MN 55369-4400 |
Alexandra E Wells | Internal Medicine | Park Nicollet Clinic | 13688 Rogers Dr, Rogers, MN 55374-4916 |
Mysoon M Ayuob | Family Medicine | Park Nicollet Clinic | 15111 Twelve Oaks Ctr Dr, Minnetonka, MN 55305-5201 |
Brian Lee Walters | Orthopedic Surgery | Park Nicollet Clinic | 14000 Fairview Dr, Burnsville, MN 55337-5713 |
Jared J Mell | Family Medicine | Park Nicollet Clinic | 4951 Excelsior Blvd, St Louis Park, MN 55416-3033 |
Sean M Reardon | Clinical Psychologist | Park Nicollet Clinic | 9555 Upland N Ln, Maple Grove, MN 55369-4485 |
Jeffrey J Mohr | Physician Assistant | Park Nicollet Clinic | 1885 Plaza Dr, Eagan, MN 55122-2979 |
Street Address |
1415 SAINT FRANCIS AVE |
City | SHAKOPEE |
State | MN |
Zip | 55379-3374 |
Name | Specialty | Organization | Address |
---|---|---|---|
Brian R Koller | Psychiatry | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
Susan J Torkelson | Obstetrics/gynecology | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
Jennifer E Grundhofer | Physician Assistant | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
Keith W Fridel | Psychologist, Clinical | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
Kaylen Jackson | Registered Dietitian Or Nutrition Professional | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
Erin Mg Smith | Physician Assistant | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
Daniel W Hauschulz | Family Medicine | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
Chelsey Arlene Sand | Family Medicine | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
Maria V Polanco | Physician Assistant | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
David A Druckman | Obstetrics/gynecology | Park Nicollet Clinic | 1415 Saint Francis Ave, Shakopee, MN 55379-3374 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Jason Douglas Eckerman | Clinical Psychologist | County of Scott | 200 4th W Ave, Suite 300, Shakopee, MN 55379-1220 |
Kim S Harmon | Clinical Social Worker | County of Scott | 200 4th Ave W, Suite 300, Shakopee, MN 55379-1220 |
Stephanie Stacy Smith | Psychologist, Clinical | County of Scott | 200 4th Ave W, Suite 300, Shakopee, MN 55379-1220 |
Danelle Amber Williams Nelson | Clinical Social Worker | County of Scott | 200 4th Ave W, Suite 300, Shakopee, MN 55379-1220 |
Erin L Martin | Psychologist, Clinical | County of Scott | 200 4th Ave W, Suite 300, Shakopee, MN 55379-1220 |
Duncan E Anderson | Psychologist, Clinical | County of Scott | 200 4th Ave W, Suite 300, Shakopee, MN 55379-1220 |
Raymond J Kennedy Iii | Psychiatry | County of Scott | 200 4th Ave W, Suite 300, Shakopee, MN 55379-1220 |
Jennifer L Schuldt | Psychologist, Clinical | County of Scott | 200 4th Ave W, Suite 300, Shakopee, MN 55379-1220 |
Morgan Claire Hittner-ashwell | Clinical Social Worker | County of Scott | 200 4th Ave W, Suite 300, Shakopee, MN 55379-1220 |
Amber Leigh Hilgart | Clinical Psychologist | County of Scott | 200 4th W Ave, Suite 300, Shakopee, MN 55379-1220 |
Find all physicians in zip 55379 |
City | SHAKOPEE |
Zip Code | 55379 |
Specialty | GENERAL SURGERY |
City + Specialty | SHAKOPEE + GENERAL SURGERY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.