Provider Demographics
NPI:1427278928
Name:GILBERT, ORIN CARLETON (PA-C)
Entity type:Individual
Prefix:MR
First Name:ORIN
Middle Name:CARLETON
Last Name:GILBERT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 STUART AVE.
Mailing Address - Street 2:MONCRIEF ARMY COMMUNITY HOSPITAL
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29207
Mailing Address - Country:US
Mailing Address - Phone:803-394-0624
Mailing Address - Fax:803-299-6680
Practice Address - Street 1:MONCRIEF ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:IMBODEN ST
Practice Address - City:FT JACKSON
Practice Address - State:SC
Practice Address - Zip Code:29207
Practice Address - Country:US
Practice Address - Phone:803-751-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCA514363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical