Healthcare Provider Details

I. General information

NPI: 1467568600
Provider Name (Legal Business Name): TIMOTHY RAYFORD GILBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 04/08/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 PERKINS RD BLDG. D
BATON ROUGE LA
70808
US

IV. Provider business mailing address

501 DR MICHAEL DEBAKEY DR
LAKE CHARLES LA
70601-5724
US

V. Phone/Fax

Practice location:
  • Phone: 225-763-0250
  • Fax: 225-763-0256
Mailing address:
  • Phone: 337-312-8258
  • Fax: 337-312-6708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number025625
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: