Provider Demographics
NPI:1275737066
Name:GILCHRIST, ALIENOR SYLVAINE (MD)
Entity Type:Individual
Prefix:
First Name:ALIENOR
Middle Name:SYLVAINE
Last Name:GILCHRIST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 COUNTRY CLUB DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9069
Mailing Address - Country:US
Mailing Address - Phone:770-474-5281
Mailing Address - Fax:770-389-8674
Practice Address - Street 1:290 COUNTRY CLUB DR
Practice Address - Street 2:SUITE 100
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9069
Practice Address - Country:US
Practice Address - Phone:770-474-5281
Practice Address - Fax:770-389-8674
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA065659208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP2-0026711OtherINSTITUTIONAL PERMIT
GA202I348149OtherMEDICARE PTAN
GAGRP6913OtherMEDICARE GROUP PTAN
BP2-0026711OtherINSTITUTIONAL PERMIT