Individual
JOHN GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(716) 845-2300
Mailing address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA09547000
NJ
2086X0206X
Surgical Oncology Physician
189632
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01706385
—
NY
Enumeration date
06/23/2005
Last updated
01/10/2025
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