Provider Demographics
NPI:1821157454
Name:GILSON, IRVING THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:THOMAS
Last Name:GILSON
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 1:38 COLWELL RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-1002
Mailing Address - Country:US
Mailing Address - Phone:401-949-0939
Mailing Address - Fax:
Practice Address - Street 1:400 BALD HILL RD
Practice Address - Street 2:SUITE 530
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1617
Practice Address - Country:US
Practice Address - Phone:401-737-9091
Practice Address - Fax:401-737-0442
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD03444207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease