Healthcare Provider Details

I. General information

NPI: 1003802356
Provider Name (Legal Business Name): JAMES MILTON GILBERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: JAMES MILTON GILBERT MD PC

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 NW 23RD ST STE B
BETHANY OK
73008-4921
US

IV. Provider business mailing address

7530 NW 23RD ST STE B
BETHANY OK
73008-4921
US

V. Phone/Fax

Practice location:
  • Phone: 405-495-6340
  • Fax: 405-440-9951
Mailing address:
  • Phone: 405-495-6340
  • Fax: 405-440-9951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9487
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: