Provider Demographics
NPI:1134564420
Name:GILBERT, PAUL DEMOULLY (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DEMOULLY
Last Name:GILBERT
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 1:2876 HILLIARD ROME RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9608
Mailing Address - Country:US
Mailing Address - Phone:614-529-4260
Mailing Address - Fax:614-529-4270
Practice Address - Street 1:2876 HILLIARD ROME RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9608
Practice Address - Country:US
Practice Address - Phone:614-529-4260
Practice Address - Fax:614-529-4270
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.145053208000000X
FLME129382208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0487417Medicaid