Gibbs, Dwayne L
Gibbs, Dwayne L is an individual health care provider with primary practice located at 630 W Maple St , Farmington NM 87401-6113. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Gibbs, Dwayne L can be contacted via phone (505) 609-6300.Contact Information
Primary practice address
630 W Maple St
Farmington NM 87401-6113
Phone: (505) 609-6300
Fax: (505) 609-6301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 91-205 | New Mexico |
Profile Details
| NPI number | 1316073141 |
|---|---|
| LBN Legal business name | Gibbs, Dwayne L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 26th, 2007 |
| Last updated | Nov 8th, 2018 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316073141 | NPPES |
| New Mexico | MEDICAID | 53885 |
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