Basic Information
| Provider Information | |||||||||
| NPI: | 1003802356 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILBERT | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | MILTON | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GILBERT | ||||||||
| OtherFirstName: | JAMES | ||||||||
| OtherMiddleName: | MILTON | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD PC | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7530 NW 23RD ST | ||||||||
| Address2: | STE B | ||||||||
| City: | BETHANY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730084921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054956340 | ||||||||
| FaxNumber: | 4054409951 | ||||||||
| Practice Location | |||||||||
| Address1: | 7530 NW 23RD ST | ||||||||
| Address2: | STE B | ||||||||
| City: | BETHANY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730084921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054956340 | ||||||||
| FaxNumber: | 4054409951 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 9487 | OK | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.