Healthcare Provider Details

I. General information

NPI: 1457361586
Provider Name (Legal Business Name): TAMELA G GILBERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3270 BLAZER PKWY SUITE 101
LEXINGTON KY
40509-2115
US

IV. Provider business mailing address

3270 BLAZER PKWY SUITE 101
LEXINGTON KY
40509-2115
US

V. Phone/Fax

Practice location:
  • Phone: 859-264-1182
  • Fax: 859-263-1187
Mailing address:
  • Phone: 859-264-1182
  • Fax: 859-263-1187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number28004
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number28004
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: