Healthcare Provider Details

I. General information

NPI: 1053593350
Provider Name (Legal Business Name): DR. DAVID GILBERT & ASSOCIATES, OPTOMETRIST, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 04/12/2010
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 TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number0601800441
License Number StateVA

VIII. Authorized Official

Name: DR. DAVID M GILBERT
Title or Position: OPTOMETRIST
Credential: OD
Phone: 757-425-0200