Individual
ANDREW R GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
43 SMITH ROAD, NEWPORT, RI 02841
(401) 841-6737
Mailing address
43 SMITH RD, NEWPORT, RI 02841-1006
(401) 841-6737
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
CA
Other
Enumeration date
11/06/2017
Last updated
01/13/2025
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