Healthcare Provider Details

I. General information

NPI: 1295857431
Provider Name (Legal Business Name): JAMES M GILBERT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 NW 23RD ST SUITE B
BETHANY OK
73008-4942
US

IV. Provider business mailing address

7530 NW 23RD ST SUITE B
BETHANY OK
73008-4942
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: JAMES GILBERT
Title or Position: OWNER DOCTOR
Credential: MD
Phone: 405-495-6340