Basic Information
| Provider Information | |||||||||
| NPI: | 1932551926 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GILBERT BARBEE MOORE & MCILVOY PSC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | GRAVES GILBERT CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 PARK ST | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421011759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707815111 | ||||||||
| FaxNumber: | 2707830454 | ||||||||
| Practice Location | |||||||||
| Address1: | 1330 N RACE ST | ||||||||
| Address2: | |||||||||
| City: | GLASGOW | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421413465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2706292780 | ||||||||
| FaxNumber: | 2708430779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2016 | ||||||||
| LastUpdateDate: | 07/28/2016 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SINCLAIR | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2707815111 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | HME01043 | KY | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.