Provider Demographics
NPI:1225633910
Name:GILBERT, GARY GENE III
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:GENE
Last Name:GILBERT
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 4TH AVE APT 31
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1523
Mailing Address - Country:US
Mailing Address - Phone:304-208-2882
Mailing Address - Fax:
Practice Address - Street 1:1123 4TH AVE APT 31
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-1523
Practice Address - Country:US
Practice Address - Phone:304-208-2882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program