Gibson, Robert Randall

Gibson, Robert Randall is an individual health care provider with primary practice located at 212 Carlanna Lake Rd Ste 100 , Ketchikan AK 99901-5642. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gibson, Robert Randall can be contacted via phone (907) 228-8140.

Contact Information

Primary practice address
212 Carlanna Lake Rd Ste 100 Ketchikan AK 99901-5642
Phone: (907) 228-8140
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5493 Alaska
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A51581 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 29061 Colorado

Profile Details

NPI number 1700904406
LBN Legal business name Gibson, Robert Randall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Jan 25th, 2013 - 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 1700904406 NPPES
Alaska MEDICAID MD3965

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