Gibbs, Kenneth

Gibbs, Kenneth is an individual health care provider with primary practice located at 415 6Th St , Lewiston ID 83501-2431. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Gibbs, Kenneth can be contacted via phone (208) 750-7445.

Contact Information

Primary practice address
415 6Th St Lewiston ID 83501-2431
Phone: (208) 750-7445
Fax: (208) 750-7395
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X ME44229 Florida
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 41676 Kentucky
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X ME44229 Florida
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 2016035277 Missouri
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X M-12671 Idaho

Profile Details

NPI number 1174506455
LBN Legal business name Gibbs, Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2005
Last updated Sep 10th, 2020 - about 5 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 1174506455 NPPES
Florida MEDICAID 005793300

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