Provider Demographics
NPI:1962965699
Name:GILBERT, ZACHARY (MD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:GILBERT
Suffix:
Gender:
Credentials:MD
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 684
Mailing Address - Street 2:
Mailing Address - City:NACHES
Mailing Address - State:WA
Mailing Address - Zip Code:98937-0684
Mailing Address - Country:US
Mailing Address - Phone:509-388-4914
Mailing Address - Fax:
Practice Address - Street 1:5440 KINGS ISLAND DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7931
Practice Address - Country:US
Practice Address - Phone:513-637-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.152042207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program