Basic Information
| Provider Information | |||||||||
| NPI: | 1982779278 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GILBERT | ||||||||
| FirstName: | FREDERICK | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 695 | ||||||||
| Address2: | |||||||||
| City: | NEWMAN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302640695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7703044062 | ||||||||
| FaxNumber: | 7702374539 | ||||||||
| Practice Location | |||||||||
| Address1: | 60 HOSPITAL RD | ||||||||
| Address2: | PATHOLOGY DEPT | ||||||||
| City: | NEWMAN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7703044062 | ||||||||
| FaxNumber: | 7702374539 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2006 | ||||||||
| LastUpdateDate: | 10/01/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 014049 | GA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.