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Individual
DR. BRANDT RYAN GIBSON
Active
Individual
DR. BRANDT RYAN GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
5093909-0501
UT
213EP1101X
Primary Podiatric Medicine Podiatrist
5093909-0501
UT
213ES0000X
Sports Medicine Podiatrist
5093909-0501
UT
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5093909-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107028407101
IHC PIN
UT
01
—
243399
ALTIUS PIN
UT
01
—
27-00195
UNITED HEALTH CARE PIN
UT
01
—
50939090500001
BCBS PIN
UT
01
—
79031
PEHP PIN
UT
01
—
882626
DMBA PIN
UT
Enumeration date
11/07/2005
Last updated
12/08/2021
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