Provider Demographics
NPI:1225128127
Name:GERBINO, LOUIS P (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:P
Last Name:GERBINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60191 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-8172
Mailing Address - Country:US
Mailing Address - Phone:712-243-3411
Mailing Address - Fax:712-243-6716
Practice Address - Street 1:1800 W 22ND ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-2976
Practice Address - Country:US
Practice Address - Phone:712-243-1058
Practice Address - Fax:712-243-1143
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA231922084P0800X
NE159992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA094961Medicaid
IA1093534Medicaid
IA094961Medicaid