Carney, Robert Gibson
Carney, Robert Gibson is an sole proprietor health care provider with primary practice located at 1770 E Lake Shore Dr Suite #301, Decatur IL 62521-3832. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Carney, Robert Gibson can be contacted via phone (217) 429-2636.Contact Information
Primary practice address
1770 E Lake Shore Dr Suite #301
Decatur IL 62521-3832
Phone: (217) 429-2636
Fax: (217) 429-2687
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 036-049753 | Illinois |
Profile Details
| NPI number | 1275598542 |
|---|---|
| LBN Legal business name | Carney, Robert Gibson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Jan 8th, 2011 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275598542 | NPPES |
| Illinois | Other | 071128778 | RR MEDICARE PROVIDER |
| Illinois | Other | 00882 | RR MEDICARE PROVIDER |
| Illinois | MEDICAID | 036049753 | RR MEDICARE PROVIDER |
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