Provider Demographics
NPI:1518907542
Name:GILBERT, JEFF (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 72ND ST STE P
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4724
Mailing Address - Country:US
Mailing Address - Phone:515-278-0456
Mailing Address - Fax:888-247-3551
Practice Address - Street 1:2600 72ND ST STE P
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4724
Practice Address - Country:US
Practice Address - Phone:515-278-0456
Practice Address - Fax:888-247-3551
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1198655Medicaid
IA1198655Medicaid