Provider Demographics
NPI:1336230747
Name:GILBERT, RICHARD LESLIE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LESLIE
Last Name:GILBERT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1041 KIRKPATRICK RD
Mailing Address - Street 2:STE 200
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8148
Mailing Address - Country:US
Mailing Address - Phone:336-584-3100
Mailing Address - Fax:336-584-0696
Practice Address - Street 1:1041 KIRKPATRICK RD
Practice Address - Street 2:STE 200
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8148
Practice Address - Country:US
Practice Address - Phone:336-584-3100
Practice Address - Fax:336-584-0696
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC31511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7935465Medicaid
NCE06704Medicare UPIN
NC2139931FMedicare ID - Type Unspecified