Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 3236/T453 | OH |
NPI | 1013027572 |
---|---|
Provider Name | Dr. Harry Robert Gilbert |
First Address | Akron, OH 44319-4128 |
Second Address | Akron, OH 44319-4128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
032690 | (05) | OH |
0465160001 | DURABLE MEDICAL GOODS (01) | OH |
T47019 | (02) | OH |