Provider Demographics
NPI:1225028855
Name:GILSON, IAN SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:SCOTT
Last Name:GILSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 N MCKENZIE ST
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-2326
Mailing Address - Country:US
Mailing Address - Phone:251-424-1130
Mailing Address - Fax:251-424-1131
Practice Address - Street 1:1813 N MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2326
Practice Address - Country:US
Practice Address - Phone:251-424-1130
Practice Address - Fax:251-424-1131
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24114207Q00000X
AL45695207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64241144Medicaid
KYC78475Medicare UPIN
KY0515202Medicare PIN
KY0525104Medicare PIN