Provider Demographics
NPI:1013027572
Name:GILBERT, HARRY ROBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:ROBERT
Last Name:GILBERT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 E TURKEYFOOT LAKE RD
Mailing Address - Street 2:SUITE 4-A
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-4128
Mailing Address - Country:US
Mailing Address - Phone:330-896-1098
Mailing Address - Fax:
Practice Address - Street 1:767 E TURKEYFOOT LAKE RD
Practice Address - Street 2:SUITE 4-A
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-4128
Practice Address - Country:US
Practice Address - Phone:330-896-1098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3236/T453152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH032690Medicaid
OH0465160001OtherDURABLE MEDICAL GOODS
OH032690Medicaid
OHT47019Medicare UPIN