Provider Demographics
NPI:1104981463
Name:GILNER, FRANK H (PHD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:H
Last Name:GILNER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 E MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6320
Mailing Address - Country:US
Mailing Address - Phone:314-966-5631
Mailing Address - Fax:314-835-1172
Practice Address - Street 1:622 E MONROE AVE
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6320
Practice Address - Country:US
Practice Address - Phone:314-966-5631
Practice Address - Fax:314-835-1172
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO42103TB0200X, 103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000070122Medicare ID - Type UnspecifiedPROVIDER NUMBER