Gilbert, Marc Randolph

Gilbert, Marc Randolph is an individual health care provider with primary practice located at 813 Troy St , Dayton OH 45404-1852. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gilbert, Marc Randolph can be contacted via phone (937) 228-2020.

Contact Information

Primary practice address
813 Troy St Dayton OH 45404-1852
Phone: (937) 228-2020
Fax: (937) 228-8769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3858T056 Ohio

Profile Details

NPI number 1659377190
LBN Legal business name Gilbert, Marc Randolph
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Jan 18th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659377190 NPPES
Ohio Other 310928411026 CARE SOURCE
Ohio Other 310928411027 CARE SOURCE
Ohio MEDICAID 0631883 CARE SOURCE

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