Provider Demographics
NPI:1669738142
Name:GILBERT MEDICAL GROUP LLC
Entity type:Organization
Organization Name:GILBERT MEDICAL GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:VOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-497-2900
Mailing Address - Street 1:754 S.VAL VISTA DR.
Mailing Address - Street 2:STE105
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296
Mailing Address - Country:US
Mailing Address - Phone:480-497-2900
Mailing Address - Fax:480-497-2906
Practice Address - Street 1:754 S VAL VISTA DR
Practice Address - Street 2:STE105
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3157
Practice Address - Country:US
Practice Address - Phone:480-497-2900
Practice Address - Fax:480-497-2906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty