Gilbert Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GILBERT INTERNAL MEDICINE LLC

Practice address

3503 South Mercy Road
Gilbert, AZ 85296

Phone

(480) 899-4420

Fax

(480) 219-3214

NPI assigned

Jun 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leo Odle, DONPI 1073601415

Title

President

Phone

(480) 899-4420

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leo Odle, DO

  • Internal Medicine Physician
  • Gilbert, AZ
  • NPI 1073601415
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114129848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1494 E TULSA ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852965550",
            "telephone_number": "480-899-4420",
            "fax_number": "480-219-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3503 SOUTH MERCY ROAD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85296",
            "telephone_number": "480-899-4420",
            "fax_number": "480-219-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILBERT INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ODLE",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-899-4420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.