Gibson, Patrick R.

Gibson, Patrick R. is an individual health care provider with primary practice located at Enfield Medical Associates 701 Enfield Street, Enfield CT 06082. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Gibson, Patrick R. can be contacted via phone (860) 741-6058.

Contact Information

Primary practice address
Enfield Medical Associates 701 Enfield Street Enfield CT 06082
Phone: (860) 741-6058
Fax: (413) 733-5860
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 510 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA510 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5858 Connecticut

Profile Details

NPI number 1861406597
LBN Legal business name Gibson, Patrick R.
Credentials PA-C, MHP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Nov 21st, 2022 - about 2 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 1861406597 NPPES
Massachusetts MEDICAID 110165973A

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