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NPI Code Detail

MEDICARE: DR. STEWART DIXON GILBERT JR. MD

MEDICARE: DR. STEWART DIXON GILBERT JR. 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
12085R0202XDiagnostic Radiology Physician51878GA

Other Identifiers

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

General Provider Information

NPI Number : 1487636445
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEWART DIXON GILBERT JR. MD
Provider Business Mailing Address
First Line : 6000 LAKE FORREST DR NW
Second Line : SUITE 475
City : ATLANTA
State : GA
Zip : 30328-3824
Country : US
Telephone Number : 404-459-8440
Fax Number :
Provider Business Practice Location Address
First Line : 303 PARKWAY DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30312-1212
Country : US
Telephone Number : 404-265-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 03/02/2018

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