Provider Demographics
NPI:1285797704
Name:GEHLBACH, BRIAN KENT (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:KENT
Last Name:GEHLBACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:K
Other - Last Name:GEHLBACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 HAWKINS DRIVE C33-GH UNIVERSITY OF IOWA HEALTH CARE
Mailing Address - Street 2:DIVISION OF PULMONARY, CRITICAL CARE, & OCCUPATIONAL ME
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242
Mailing Address - Country:US
Mailing Address - Phone:319-356-3603
Mailing Address - Fax:319-353-6406
Practice Address - Street 1:200 HAWKINS DRIVE C33-GH UNIVERSITY OF IOWA HEALTH CARE
Practice Address - Street 2:DIVISION OF PULMONARY, CRITICAL CARE, & OCCUPATIONAL ME
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-356-3603
Practice Address - Fax:319-353-6406
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA39594207RC0200X, 207R00000X, 207RP1001X
IL036097202207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097202Medicaid