Healthcare Provider Details

I. General information

NPI: 1033178082
Provider Name (Legal Business Name): DAVID M GILBERT OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1547 LASKIN RD
VIRGINIA BEACH VA
23451-6111
US

IV. Provider business mailing address

1547 LASKIN RD
VIRGINIA BEACH VA
23451-6111
US

V. Phone/Fax

Practice location:
  • Phone: 757-425-0200
  • Fax: 757-428-2823
Mailing address:
  • Phone: 757-425-0200
  • Fax: 757-428-2823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0601800441
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number0601800441
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: