Provider Demographics
NPI:1710369558
Name:GILBERT, JEFFREY LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LEE
Last Name:GILBERT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JEFF
Other - Middle Name:LEE
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:597 DONALD C MOORE DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:VA
Mailing Address - Zip Code:24266-4847
Mailing Address - Country:US
Mailing Address - Phone:276-312-9511
Mailing Address - Fax:
Practice Address - Street 1:2200 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-3385
Practice Address - Country:US
Practice Address - Phone:423-246-0234
Practice Address - Fax:423-246-0148
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-28
Last Update Date:2023-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202213992183500000X
TN45034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist