Provider Demographics
NPI:1427211804
Name:GILBERT CHILDRENS MEDICAL GROUP INC
Entity Type:Organization
Organization Name:GILBERT CHILDRENS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:KERIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-633-3577
Mailing Address - Street 1:4540 E BASELINE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4616
Mailing Address - Country:US
Mailing Address - Phone:480-892-3880
Mailing Address - Fax:480-545-4551
Practice Address - Street 1:4540 E BASELINE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4616
Practice Address - Country:US
Practice Address - Phone:480-892-3880
Practice Address - Fax:480-545-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty