Provider Demographics
NPI:1760470967
Name:TOFFOL, GILBERT J (DO)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:J
Last Name:TOFFOL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 E MCKELLIPS RD
Mailing Address - Street 2:STE 102
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-2844
Mailing Address - Country:US
Mailing Address - Phone:480-834-9575
Mailing Address - Fax:480-834-4497
Practice Address - Street 1:1919 E MCKELLIPS RD
Practice Address - Street 2:STE 102
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2844
Practice Address - Country:US
Practice Address - Phone:480-834-9575
Practice Address - Fax:480-834-4497
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ23652084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ276974Medicaid
AZZ76048Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL NUMBE
AZE20662Medicare UPIN