Provider Demographics
NPI:1881685816
Name:GILBERT, ROBERT W JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:GILBERT
Suffix:JR
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 1:95 COLLIER RD
Mailing Address - Street 2:SUITE 4045 PEACHTREE NEUROLOGICAL CLINIC
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309
Mailing Address - Country:US
Mailing Address - Phone:404-351-2270
Mailing Address - Fax:404-352-1969
Practice Address - Street 1:95 COLLIER RD
Practice Address - Street 2:SUITE 4045 PEACHTREE NEUROLOGICAL CLINIC
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-351-2270
Practice Address - Fax:404-352-1969
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0184912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00136254IMedicaid
GA13BDCHKMedicare PIN
GAD39948Medicare UPIN
GA13BDDRQMedicare PIN