Gibson, Kermit Donald

Gibson, Kermit Donald is an sole proprietor health care provider with primary practice located at 905 W Russell St , Elkhorn City KY 41522-7071. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Gibson, Kermit Donald can be contacted via phone (606) 754-4158.

Contact Information

Primary practice address
905 W Russell St Elkhorn City KY 41522-7071
Phone: (606) 754-4158
Fax: (606) 754-5452
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 02080 Kentucky

Profile Details

NPI number 1083760649
LBN Legal business name Gibson, Kermit Donald
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2007
Last updated Sep 26th, 2012 - about 13 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 1083760649 NPPES
Kentucky MEDICAID 64020803
Kentucky Other 112617
Kentucky Other 1270152

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