MEDICARE: DR. GILBERT KEITH CHRISTY MD

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	207Y00000X	Otolaryngology Physician	016819	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396779641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GILBERT KEITH CHRISTY MD

Provider Business Mailing Address
First Line	:	2449 HOSPITAL DR STE 440
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-1918
Country	:	US
Telephone Number	:	318-212-7288
Fax Number	:	318-212-7295

Provider Business Practice Location Address
First Line	:	2449 HOSPITAL DR STE 440
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-1918
Country	:	US
Telephone Number	:	318-212-7288
Fax Number	:	318-212-7295

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	06/22/2021

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