Provider Demographics
NPI:1053547356
Name:GILBERT, DOUGLAS JAY (PHD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:JAY
Last Name:GILBERT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3328 STONERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2856
Mailing Address - Country:US
Mailing Address - Phone:205-967-6755
Mailing Address - Fax:
Practice Address - Street 1:3328 STONERIDGE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223-2856
Practice Address - Country:US
Practice Address - Phone:205-967-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist