MEDICARE: JEFFREY K GILBERTSON MD PA

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	207Q00000X	Family Medicine Physician

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	:	1669581435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY K GILBERTSON MD PA

Provider Business Mailing Address
First Line	:	PO BOX 1627
Second Line	:
City	:	GRAHAM
State	:	TX
Zip	:	76450
Country	:	US
Telephone Number	:	940-549-0039
Fax Number	:	940-549-0073

Provider Business Practice Location Address
First Line	:	1804 STATE HIGHWAY 16 S
Second Line	:
City	:	GRAHAM
State	:	TX
Zip	:	76450-4608
Country	:	US
Telephone Number	:	940-549-0039
Fax Number	:	940-549-0073

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY K GILBERTSON
Credential	:	MD
Telephone Number	:	940-549-0039

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	02/29/2016

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