Organization
GATEWOOD PROSTHETICS INC
Active
Organization
GATEWOOD PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE GATEWOOD CPO,CPED (OWNER,PROSTHETIST,ORTHOTIST,PEDORTH)
(706) 596-8004
Entity
Organization
Contact information
Practice address
2515 OLD WHITTLESEY RD, SUITE A, COLUMBUS, GA 31909-3020
(706) 596-8004
(706) 327-3388
Mailing address
PO BOX 1623, FORTSON, GA 31808-1623
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000071
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00919553A
—
GA
01
—
138773
PEACHSTATE
GA
01
—
N343442
WELLCARE
GA
Enumeration date
11/02/2007
Last updated
10/21/2013
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