Provider Demographics
NPI:1689080517
Name:GILBERT, KURT (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:GILBERT
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:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570
Mailing Address - Country:US
Mailing Address - Phone:931-403-1197
Mailing Address - Fax:931-403-2615
Practice Address - Street 1:315 OAK ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1728
Practice Address - Country:US
Practice Address - Phone:931-823-5611
Practice Address - Fax:931-403-2615
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPME262207R00000X
GA86050207R00000X
COCDR.0000754207R00000X
MN67599207R00000X
AZ61583207R00000X
IAMD-47518207R00000X
WAMD61084257207R00000X
OK37051207R00000X
TXS7219207R00000X
NY304960207R00000X
WI876-320207R00000X
KS04-43443207R00000X
MS27919207R00000X
ALMD.40905207R00000X
TN56018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine