Provider Demographics
NPI:1376330498
Name:GILMORE, CHELBI (DO)
Entity type:Individual
Prefix:
First Name:CHELBI
Middle Name:
Last Name:GILMORE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHELBI
Other - Middle Name:ANDRAYA GILMORE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:2623 WINDSONG PL
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-8012
Mailing Address - Country:US
Mailing Address - Phone:479-806-6104
Mailing Address - Fax:
Practice Address - Street 1:4301 WEST MARKHAM, SLOT 589
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-526-8161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program