Gibson, Wendy S.
Gibson, Wendy S. is an sole proprietor health care provider with primary practice located at 1512 Main St , Benton KY 42025-1607. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Suppliers / Eyewear Supplier (Equipment, not the service). Eye and Vision Services Providers / Optometrist is her primary health care specialty. Gibson, Wendy S. can be contacted via phone (270) 527-0951.Contact Information
Primary practice address
1512 Main St
Benton KY 42025-1607
Phone: (270) 527-0951
Fax: (270) 527-1316
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 911DT | Kentucky |
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X | 911DT | Kentucky |
Profile Details
| NPI number | 1649345190 |
|---|---|
| LBN Legal business name | Gibson, Wendy S. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 21st, 2006 |
| Last updated | Nov 14th, 2013 - 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 | 1649345190 | NPPES |
| Kentucky | MEDICAID | 77009116 |
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