Gibson, John M
Gibson, John M is an individual health care provider with primary practice located at 1615 Delaware St , Longview WA 98632-2310. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Gibson, John M can be contacted via phone (360) 414-2000.Contact Information
Primary practice address
1615 Delaware St
Longview WA 98632-2310
Phone: (360) 414-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD00047671 | Washington |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD183368 | Oregon |
Profile Details
| NPI number | 1720288681 |
|---|---|
| LBN Legal business name | Gibson, John M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2007 |
| Last updated | Mar 25th, 2024 - about last year |
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 | 1720288681 | NPPES |
| Washington | MEDICAID | 8489247 | |
| Washington | MEDICAID | 274621 |
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