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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 18 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 1396789780 NPPES
Idaho MEDICAID 003716100

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