MEDICARE: MS. MARGIE GAULDEN GILBERT MSW, LCSW, PIP

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	1041C0700X	Clinical Social Worker	0601-1666C	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51512924GIL	OTHER	AL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1861539439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGIE GAULDEN GILBERT MSW, LCSW, PIP

Provider Business Mailing Address
First Line	:	3565 LORNARIDGE DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35216-5246
Country	:	US
Telephone Number	:	205-823-8449
Fax Number	:	205-823-9918

Provider Business Practice Location Address
First Line	:	3565 LORNA RIDGE DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35216-5246
Country	:	US
Telephone Number	:	205-823-8449
Fax Number	:	205-823-9918

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	07/08/2007

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