Provider Demographics
NPI:1639275795
Name:GILKEY, SANDRA CAPPS (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:CAPPS
Last Name:GILKEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:CAPPS
Other - Last Name:GILKEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:419 S HOPKINSVILLE ST
Mailing Address - Street 2:
Mailing Address - City:NORTONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42442-9762
Mailing Address - Country:US
Mailing Address - Phone:270-399-0749
Mailing Address - Fax:270-676-6065
Practice Address - Street 1:419 S HOPKINSVILLE ST
Practice Address - Street 2:
Practice Address - City:NORTONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42442-9762
Practice Address - Country:US
Practice Address - Phone:270-399-0749
Practice Address - Fax:270-676-6065
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY39100OtherLICENSE
KY64076656Medicaid
KY64076656Medicaid
0735777Medicare PIN
KY39100OtherLICENSE
0691663Medicare PIN
0745811Medicare PIN
0601411Medicare PIN
0771905Medicare PIN
KY64076656Medicaid
0903607Medicare PIN
0396838Medicare PIN
0374796Medicare PIN
0683221Medicare PIN