Provider Demographics
NPI:1386793602
Name:GILBERT, JANET L (DO)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:GILBERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 N JESSE JAMES RD
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR SPGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024
Mailing Address - Country:US
Mailing Address - Phone:816-630-6071
Mailing Address - Fax:816-630-4465
Practice Address - Street 1:15415 HWY 92
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060
Practice Address - Country:US
Practice Address - Phone:816-628-6128
Practice Address - Fax:816-628-6710
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO22894207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83749Medicare UPIN
MOD275159Medicare PIN