MEDICARE: DR. JAMES D 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
1	207X00000X	Orthopaedic Surgery Physician	4301033979	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1703908761	OTHER	MI	BCBS IND PIN

General Provider Information

NPI Number	:	1558305193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES D GILBERT M.D.

Provider Business Mailing Address
First Line	:	2318 GULL RD
Second Line	:	SUITE A-1
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-3619
Country	:	US
Telephone Number	:	269-353-9821
Fax Number	:	269-353-9857

Provider Business Practice Location Address
First Line	:	2318 GULL RD
Second Line	:	SUITE A-1
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-3619
Country	:	US
Telephone Number	:	269-353-9821
Fax Number	:	269-353-9857

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	08/14/2007

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