Jackson-Gibson, Carol Ann

Jackson-Gibson, Carol Ann is an individual health care provider with primary practice located at 1150 Youngs Rd Suite 111, Williamsville NY 14221-8053. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Jackson-Gibson, Carol Ann can be contacted via phone (716) 688-7622.

Contact Information

Primary practice address
1150 Youngs Rd Suite 111 Williamsville NY 14221-8053
Phone: (716) 688-7622
Fax: (716) 688-7592
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X 176786 New York
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 176786 New York

Profile Details

NPI number 1164421442
LBN Legal business name Jackson-Gibson, Carol Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Mar 11th, 2013 - about 11 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 1164421442 NPPES
New York Other 5609475 INDEPENDENT HEALTH #
New York MEDICAID 01598136 INDEPENDENT HEALTH #
New York Other 000525515015 INDEPENDENT HEALTH #
New York Other 150589FF INDEPENDENT HEALTH #
New York Other 300118785 INDEPENDENT HEALTH #
New York Other CR-DRA176786-2W INDEPENDENT HEALTH #
New York Other 00025193901 INDEPENDENT HEALTH #

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