Provider Demographics
NPI:1205066008
Name:GILBERTSON, CHELSEY DEE (DO)
Entity type:Individual
Prefix:DR
First Name:CHELSEY
Middle Name:DEE
Last Name:GILBERTSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHELSEY
Other - Middle Name:DEE
Other - Last Name:COBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34 SW 89TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-8510
Mailing Address - Country:US
Mailing Address - Phone:405-488-0750
Mailing Address - Fax:
Practice Address - Street 1:34 SW 89TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-8510
Practice Address - Country:US
Practice Address - Phone:405-488-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4763207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200247870AMedicaid
OKOKA100117Medicare PIN