Provider Demographics
NPI:1851381396
Name:GILBERT, JOHN CHARLES (D O)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:GILBERT
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-1595
Mailing Address - Country:US
Mailing Address - Phone:606-408-4000
Mailing Address - Fax:
Practice Address - Street 1:2001 SCIOTO TRL
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2845
Practice Address - Country:US
Practice Address - Phone:740-353-1978
Practice Address - Fax:740-354-9351
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005257G207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0828313Medicaid
OH110064504OtherTRAVELERS MEDICARE
OH000000077333OtherANTHEM
KY64933260OtherUNISYS KENTUCKY MEDICAID
OH0401024OtherUNITED HEALTH CARE
OHGI0698399Medicare ID - Type Unspecified
OH0828313Medicaid
OH0401024OtherUNITED HEALTH CARE