Provider Demographics
NPI:1205838877
Name:CHILD, GILBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:C
Last Name:CHILD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6420 SW MACADAM AVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3507
Mailing Address - Country:US
Mailing Address - Phone:503-244-8601
Mailing Address - Fax:503-244-8738
Practice Address - Street 1:9155 SW BARNES RD
Practice Address - Street 2:336
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6625
Practice Address - Country:US
Practice Address - Phone:503-292-0848
Practice Address - Fax:503-296-0635
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2008-05-28
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Provider Licenses
StateLicense IDTaxonomies
ORMD11128207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR066159Medicaid
OR180015176OtherRAILROAD MEDICARE
OR180015176OtherRAILROAD MEDICARE
OR00WCQKPAMedicare PIN