Individual
JILL D GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1313 E OSBORN RD STE 250, PHOENIX, AZ 85014-5699
(602) 265-9161
(602) 265-1823
Mailing address
1313 E OSBORN RD STE 250, PHOENIX, AZ 85014-5699
(602) 265-9161
(602) 265-1823
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
NOT YET ISSUED
CA
207VG0400X
Gynecology Physician
Primary
47651
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
809194
—
AZ
Enumeration date
07/07/2009
Last updated
09/18/2015
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