Gibson, Gary R

Gibson, Gary R is an individual health care provider with primary practice located at 310 Windsor Dr , Cortland OH 44410-2705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Gibson, Gary R can be contacted via phone (330) 637-0356.

Contact Information

Primary practice address
310 Windsor Dr Cortland OH 44410-2705
Phone: (330) 637-0356
Fax: (330) 637-0361
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35048883 Ohio

Profile Details

NPI number 1821097486
LBN Legal business name Gibson, Gary R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Jan 6th, 2011 - about 15 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 1821097486 NPPES
Ohio Other 4122159 AETNA
Ohio Other 000000147036 AETNA
Ohio MEDICAID 0631865 AETNA

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