Gibson, Larry Elisha
Gibson, Larry Elisha is an sole proprietor health care provider with primary practice located at 3333 Northside Dr Suite G, Macon GA 31210-2588. He recently has only one registered license in Chiropractic Providers / Orthopedic, which is considered as his primary health care specialty. Gibson, Larry Elisha can be contacted via phone (478) 477-4415.Contact Information
Primary practice address
3333 Northside Dr Suite G
Macon GA 31210-2588
Phone: (478) 477-4415
Fax: (478) 477-4419
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Orthopedic | 111NX0800X | CHIR001656 | Georgia |
Profile Details
| NPI number | 1093830549 |
|---|---|
| LBN Legal business name | Gibson, Larry Elisha |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 20th, 2007 |
| Last updated | May 27th, 2010 - about 14 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 | 1093830549 | NPPES |
| Georgia | Other | 202I354140 | MEDICARE PTAN |
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