Provider Demographics
NPI:1447362645
Name:LEPEL, GILBERT EARL (PA-C)
Entity type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:EARL
Last Name:LEPEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:BERT
Other - Middle Name:EARL
Other - Last Name:LEPEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:216 14TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:MT
Mailing Address - Zip Code:59270-3519
Mailing Address - Country:US
Mailing Address - Phone:406-488-2100
Mailing Address - Fax:406-433-2125
Practice Address - Street 1:214 14TH AVE SW
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:MT
Practice Address - Zip Code:59270-3521
Practice Address - Country:US
Practice Address - Phone:406-488-2100
Practice Address - Fax:406-488-2125
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0349363A00000X
MT49363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0438549Medicaid
MT0438549Medicaid