Gibson, Jimmy R.
Gibson, Jimmy R. is an individual health care provider with primary practice located at 302 N Main St , Carlsbad NM 88220-5896. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Gibson, Jimmy R. can be contacted via phone (575) 885-0956.Contact Information
Primary practice address
302 N Main St
Carlsbad NM 88220-5896
Phone: (575) 885-0956
Fax: (575) 234-9854
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | X-07673 | New Mexico |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1544 | Kentucky |
Profile Details
| NPI number | 1093803314 |
|---|---|
| LBN Legal business name | Gibson, Jimmy R. |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2006 |
| Last updated | Mar 27th, 2012 - about 12 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 | 1093803314 | NPPES |
| Kentucky | Other | 000000375385 | ANTHEM BC/BS |
| Kentucky | Other | 1164437 | ANTHEM BC/BS |
| Kentucky | Other | 611549000 | ANTHEM BC/BS |
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