Healthcare Provider Details
I. General information
NPI: 1336146638
Provider Name (Legal Business Name): JOHN GILBERT OAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/30/2005
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
920 N HAMILTON RD STE 500
GAHANNA OH
43230-1757
US
IV. Provider business mailing address
700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US
V. Phone/Fax
- Phone: 614-293-4969
- Fax: 614-293-6111
- Phone: 614-293-4969
- Fax: 614-293-6111
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 35.074548 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: