Provider Demographics
NPI:1215153929
Name:GILBERT, JEFFERY A (DO)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:A
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NORTH ACADEMY AVENUE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:217 SOUTH LOGAN BLVD.
Practice Address - Street 2:
Practice Address - City:BURNHAM
Practice Address - State:PA
Practice Address - Zip Code:17009
Practice Address - Country:US
Practice Address - Phone:717-248-5431
Practice Address - Fax:717-248-5038
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012774207R00000X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology