Healthcare Provider Details

I. General information

NPI: 1720423189
Provider Name (Legal Business Name): MEGHAN CARROLL GILBERT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 NICHOLASVILLE RD
LEXINGTON KY
40503-1431
US

IV. Provider business mailing address

1401 HARRODSBURG RD STE C335
LEXINGTON KY
40504-1791
US

V. Phone/Fax

Practice location:
  • Phone: 859-260-6348
  • Fax:
Mailing address:
  • Phone: 859-276-5355
  • Fax: 859-277-1843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101020242
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number04280
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: