Provider Demographics
NPI:1891789848
Name:THAYER, GILBERT MICHEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:MICHEAL
Last Name:THAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-0655
Mailing Address - Country:US
Mailing Address - Phone:731-925-2300
Mailing Address - Fax:731-925-3506
Practice Address - Street 1:105 DAVIS ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372-1855
Practice Address - Country:US
Practice Address - Phone:731-925-8879
Practice Address - Fax:731-925-2668
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD25714207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1169884OtherUNITED HEALTHCARE
TN30867841OtherMEDICARE ID
TN4066013OtherBLUE CROSS BLUE SHIELD
4215284OtherBCBS
TN160051552OtherRAILROAD MEDICAID
TN2568412OtherCIGNA
TN626001636OtherBHSG
TN3086784Medicaid
TN626001636OtherBHSG
TN30867841OtherMEDICARE ID
TN3086788Medicare ID - Type Unspecified