Gibson, Michael J

Gibson, Michael J is an individual health care provider with primary practice located at 100 Mcdougal Dr , Holdenville OK 74848-2822. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Gibson, Michael J can be contacted via phone (405) 379-4202.

Contact Information

Primary practice address
100 Mcdougal Dr Holdenville OK 74848-2822
Phone: (405) 379-4202
Fax: (405) 379-4340
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 199 Oklahoma

Profile Details

NPI number 1487681201
LBN Legal business name Gibson, Michael J
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Oct 17th, 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 1487681201 NPPES
Other 0784740001 DMERC REGION C
MEDICAID 100848080A DMERC REGION C
Other P00266954 DMERC REGION C

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