Provider Demographics
NPI:1750488938
Name:CHRISTI L GILBERT DPM PA
Entity Type:Organization
Organization Name:CHRISTI L GILBERT DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:L
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:785-841-3338
Mailing Address - Street 1:3120 MESA WAY
Mailing Address - Street 2:STE A
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049
Mailing Address - Country:US
Mailing Address - Phone:785-841-3338
Mailing Address - Fax:785-841-3340
Practice Address - Street 1:3120 MESA WAY
Practice Address - Street 2:STE A
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049
Practice Address - Country:US
Practice Address - Phone:785-841-3338
Practice Address - Fax:785-841-3340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1200323213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
30298028OtherBCBSKC
KS5117870001Medicare NSC
KS114112Medicare ID - Type Unspecified
U86059Medicare UPIN