Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4887 | OH |
NPI | 1003816950 |
---|---|
Provider Name | Dr. Diana Watkins Gilbert |
First Address | West Chester, OH 45069-4885 |
Second Address | West Chester, OH 45069-4885 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 16/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U71465 | (02) | OH |