Provider Demographics
NPI:1265964100
Name:GILBERT, JACQUELYN TAYLOR (MD)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:TAYLOR
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 S 8TH ST STE 480W
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2403
Mailing Address - Country:US
Mailing Address - Phone:270-762-1321
Mailing Address - Fax:270-767-3667
Practice Address - Street 1:300 S 8TH ST STE 208E
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2472
Practice Address - Country:US
Practice Address - Phone:270-759-9223
Practice Address - Fax:844-560-2472
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY56098208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics