Provider Demographics
NPI:1003802356
Name:GILBERT, JAMES MILTON (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MILTON
Last Name:GILBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:MILTON
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PC
Mailing Address - Street 1:7530 NW 23RD ST
Mailing Address - Street 2:STE B
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-4921
Mailing Address - Country:US
Mailing Address - Phone:405-495-6340
Mailing Address - Fax:405-440-9951
Practice Address - Street 1:7530 NW 23RD ST
Practice Address - Street 2:STE B
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-4921
Practice Address - Country:US
Practice Address - Phone:405-495-6340
Practice Address - Fax:405-440-9951
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK94872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D39127Medicare UPIN