MEDICARE: DR. JOHN DAVID GILBERTSON 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	207R00000X	Internal Medicine Physician	NV 7390	NV

General Provider Information

NPI Number	:	1700890548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DAVID GILBERTSON MD

Provider Business Mailing Address
First Line	:	816 WEST OWENS AVE
Second Line	:	VA NORTH CLINIC
City	:	LAS VEGAS
State	:	NV
Zip	:	89036-2516
Country	:	US
Telephone Number	:	702-636-3000
Fax Number	:	702-636-3007

Provider Business Practice Location Address
First Line	:	816 WEST OWENS AVE
Second Line	:	VA NORTH CLINIC
City	:	LAS VEGAS
State	:	NV
Zip	:	89036-2516
Country	:	US
Telephone Number	:	702-636-3000
Fax Number	:	702-636-3007

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/08/2007

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