Individual
DR. MARC RANDOLPH GILBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
813 TROY ST, DAYTON, OH 45404-1852
(937) 228-2020
(937) 228-8769
Mailing address
813 TROY ST, DAYTON, OH 45404-1852
(937) 228-2020
(937) 228-8769
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3858T056
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0631883
—
OH
01
—
310928411026
CARE SOURCE
OH
01
—
310928411027
CARE SOURCE
OH
Enumeration date
06/21/2005
Last updated
01/18/2008
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