| Gilbert Internal Medicine Llc | |
|
3503 South Mercy Road Gilbert AZ 85296 | |
| (480) 899-4420 | |
| (480) 219-3214 |
| Full Name | Gilbert Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3503 South Mercy Road, Gilbert, Arizona |
| Authorized Official Name and Position | Leo Odle (PRESIDENT) |
| Authorized Official Contact | 4808994420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gilbert Internal Medicine Llc 1494 E Tulsa St Gilbert AZ 85296-5550 Ph: (480) 899-4420 | Gilbert Internal Medicine Llc 3503 South Mercy Road Gilbert AZ 85296 Ph: (480) 899-4420 |
| NPI Number | 1114129848 |
|---|---|
| Provider Enumeration Date | 06/04/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6800996331 |
|---|---|
| Medicare Enrollment ID | O20070712000190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114129848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Leo Odle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073601415 PECOS PAC ID: 5597759340 Enrollment ID: I20070515000298 |
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