Provider Demographics
NPI:1114957461
Name:GILBERT, JULIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:KURIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1557 TALBOT RD SE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:OR
Mailing Address - Zip Code:97352
Mailing Address - Country:US
Mailing Address - Phone:971-273-7143
Mailing Address - Fax:971-915-0321
Practice Address - Street 1:1557 TALBOT RD SE
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:OR
Practice Address - Zip Code:97352
Practice Address - Country:US
Practice Address - Phone:971-273-7143
Practice Address - Fax:971-915-0321
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19085207Q00000X, 207QB0002X
ORMD19085207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR026478Medicaid
ORR157126OtherMEDICARE PTAN
ORF85263Medicare UPIN