Provider Demographics
NPI:1053688135
Name:REHAB DOC, INC.
Entity type:Organization
Organization Name:REHAB DOC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-445-9799
Mailing Address - Street 1:3379 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 555
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1031
Mailing Address - Country:US
Mailing Address - Phone:404-682-0767
Mailing Address - Fax:404-682-0766
Practice Address - Street 1:3379 PEACHTREE RD NE
Practice Address - Street 2:SUITE 555
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1031
Practice Address - Country:US
Practice Address - Phone:404-682-0767
Practice Address - Fax:888-650-8387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62848208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202G703642Medicare PIN