Gibson, Theodore Dwayne

Gibson, Theodore Dwayne is an individual health care provider with primary practice located at 1500 S Lake Park Ave , Hobart IN 46342-6638. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Surgical Technologist, which is considered as his primary health care specialty. Gibson, Theodore Dwayne can be contacted via phone (219) 947-6425.

Contact Information

Primary practice address
1500 S Lake Park Ave Hobart IN 46342-6638
Phone: (219) 947-6425
Fax: (219) 947-6424
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Surgical Technologist 246ZS0410X

Profile Details

NPI number 1639152473
LBN Legal business name Gibson, Theodore Dwayne
Credentials CST/CFA
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 25th, 2005
Last updated Jul 8th, 2007 - about 17 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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