Gibbons, Jeffrey Eugene

Gibbons, Jeffrey Eugene is an individual health care provider with primary practice located at 855 W 6Th S , Mountain Home ID 83647-3335. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gibbons, Jeffrey Eugene can be contacted via phone (208) 587-2020.

Contact Information

Primary practice address
855 W 6Th S Mountain Home ID 83647-3335
Phone: (208) 587-2020
Fax: (208) 587-3349
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP995 Idaho

Profile Details

NPI number 1568427615
LBN Legal business name Gibbons, Jeffrey Eugene
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Apr 4th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568427615 NPPES
Idaho MEDICAID 806081500

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