Provider Demographics
NPI:1962686451
Name:DR. DAVID GILBERT & ASSOCIATES, OPTOMETRIST, PC
Entity Type:Organization
Organization Name:DR. DAVID GILBERT & ASSOCIATES, OPTOMETRIST, PC
Other - Org Name:GILBERT EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-622-0200
Mailing Address - Street 1:220 W BRAMBLETON AVE
Mailing Address - Street 2:STE 111
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1506
Mailing Address - Country:US
Mailing Address - Phone:757-622-0200
Mailing Address - Fax:757-627-0408
Practice Address - Street 1:220 W BRAMBLETON AVE
Practice Address - Street 2:STE 111
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1506
Practice Address - Country:US
Practice Address - Phone:757-622-0200
Practice Address - Fax:757-627-0408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0601800441152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA386480OtherANTHEM BC/BS PROVIDER ID
VAVA0441OtherEYEMED PROVIDER ID#
VA70247OtherSENTARA PROVIDER ID #
VA386480OtherANTHEM BC/BS PROVIDER ID
VA=========OtherUNITED HEALTHCARE PROVIDE
C08706Medicare PIN
VA=========OtherVSP PROVIDER ID
VADC1240Medicare PIN