Individual
TIMOTHY GILBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
121 PATTON DRIVE, PONCA CITY, OK 74601
(580) 762-6676
(580) 762-0094
Mailing address
121 PATTON DRIVE, PONCA CITY, OK 74601
(580) 762-6676
(580) 762-0094
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14301
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10095390A
—
OK
Enumeration date
03/30/2006
Last updated
11/09/2021
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