Provider Demographics
NPI:1306093265
Name:HICE, GILBERT ALAN (DPM MS)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:ALAN
Last Name:HICE
Suffix:
Gender:M
Credentials:DPM MS
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Mailing Address - Street 1:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:GOLD HILL
Mailing Address - State:OR
Mailing Address - Zip Code:97525
Mailing Address - Country:US
Mailing Address - Phone:541-582-3880
Mailing Address - Fax:541-582-3880
Practice Address - Street 1:953 FOOTS CREEK ROAD
Practice Address - Street 2:
Practice Address - City:GOLD HILL
Practice Address - State:OR
Practice Address - Zip Code:97525
Practice Address - Country:US
Practice Address - Phone:541-582-3880
Practice Address - Fax:541-582-3880
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP00121213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist