Gibson, Michael P
Gibson, Michael P is an individual health care provider with primary practice located at 6533 W Emerald St , Boise ID 83704-8737. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Occupational Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Occupational Medicine is his primary health care specialty. Gibson, Michael P can be contacted via phone (208) 367-4197.Contact Information
Primary practice address
6533 W Emerald St
Boise ID 83704-8737
Phone: (208) 367-4197
Fax: (208) 367-8136
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | M3046 | Idaho |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M-3046 | Idaho |
Profile Details
| NPI number | 1396789780 |
|---|---|
| LBN Legal business name | Gibson, Michael P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Dec 31st, 2008 - about 17 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 | 1396789780 | NPPES |
| Idaho | MEDICAID | 003716100 |
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