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NPI Code Detail

MEDICARE: DR. GEORGE CARLTON GILBERT M.D.

MEDICARE: DR. GEORGE CARLTON GILBERT M.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
1207QA0401XAddiction Medicine (Family Medicine) Physician036077426IL
2207Q00000XFamily Medicine Physician036077426IL

General Provider Information

NPI Number : 1215021100
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE CARLTON GILBERT M.D.
Provider Business Mailing Address
First Line : PO BOX 9727
Second Line :
City : PEORIA
State : IL
Zip : 61612-9727
Country : US
Telephone Number : 309-886-9172
Fax Number : 309-509-4045
Provider Business Practice Location Address
First Line : 3525 N UNIVERSITY ST
Second Line :
City : PEORIA
State : IL
Zip : 61604-1324
Country : US
Telephone Number : 309-886-9172
Fax Number : 309-509-4045
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 12/22/2023

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