Individual
ROGER W GILBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
500 W THOMAS RD STE 850, PHOENIX, AZ 85013-4218
(602) 406-1150
(602) 406-1159
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
165335
MT
363AS0400X
Surgical Physician Assistant
Primary
3209
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3209
AZ LICENSE
AZ
05
—
961111
—
AZ
Enumeration date
08/22/2005
Last updated
12/04/2025
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