Provider Demographics
NPI:1740245596
Name:GILBERT PODIATRY ASSOCIATES INC
Entity Type:Organization
Organization Name:GILBERT PODIATRY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-681-6577
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:PA
Mailing Address - Zip Code:18331-0125
Mailing Address - Country:US
Mailing Address - Phone:610-681-6577
Mailing Address - Fax:
Practice Address - Street 1:RTE 209
Practice Address - Street 2:GILBERT MEDICAL CENTER, SUITE D
Practice Address - City:GILBERT
Practice Address - State:PA
Practice Address - Zip Code:18331-0125
Practice Address - Country:US
Practice Address - Phone:610-681-6577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA077956Medicare ID - Type Unspecified
PA5136770001Medicare NSC