Individual
DR. DUANE PHILLIP GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
817 COURT ST, SUITE 10, JACKSON, CA 95642-2156
(209) 223-2020
(209) 223-2046
Mailing address
817 COURT ST, SUITE 10, JACKSON, CA 95642-2156
(209) 223-2020
(209) 223-2046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10077T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0100771
—
CA
Enumeration date
09/14/2005
Last updated
12/12/2007
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