MEDICARE: DR. DOUGLAS JAY GILBERT PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	667	AL

General Provider Information

NPI Number	:	1053547356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS JAY GILBERT PH.D.

Provider Business Mailing Address
First Line	:	3328 STONERIDGE DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35223-2856
Country	:	US
Telephone Number	:	205-967-6755
Fax Number	:

Provider Business Practice Location Address
First Line	:	3328 STONERIDGE DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35223-2856
Country	:	US
Telephone Number	:	205-967-6755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2009
Last Update Date	:	06/02/2009

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