Provider Demographics
NPI:1720051501
Name:GILBERT, JOHN W (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:GILBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3256 LOCH NESS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-1239
Mailing Address - Country:US
Mailing Address - Phone:859-971-0014
Mailing Address - Fax:859-971-0074
Practice Address - Street 1:3256 LOCH NESS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-1239
Practice Address - Country:US
Practice Address - Phone:859-971-0014
Practice Address - Fax:859-971-0074
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY23998207T00000X, 2085N0700X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY140003490OtherRAILROAD MCARE PIN
KY64239981Medicaid
KY0316501Medicare PIN
KY0689703Medicare PIN
KY0560003Medicare PIN
KY64239981Medicaid
KYC78387Medicare UPIN
KYK114591Medicare PIN
KY0912301Medicare PIN