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General NPI Number Information
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NPI Number | 1245471259
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Entity Type | Individual
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Provider Name | ALISSA MICHELLE GILBERT M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/20/2009
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Last Update Date | 01/15/2019
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Provider Practice Location Address
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Address Line | 3666 PAXTON AVE
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City | CINCINNATI
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State | OH
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Zip | 45208
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Country | US
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Telephone | 513-871-0684
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Fax |
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Provider Business Mailing Address
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Address Line | 106 HETHERINGTON LN
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City | CINCINNATI
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State | OH
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Zip | 45246-3744
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Country | US
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Telephone | 330-715-4677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35.096580
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License Number State | OH
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