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Individual

DR. SARA FAITH GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1300 S YALE ST, FLAGSTAFF, AZ 86001-6328
(928) 774-7128
Mailing address
PO BOX 579, 470 W CLEVELAND, SAINT JOHNS, AZ 85936-0579
(928) 333-2683
(928) 333-5595

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
19950
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ0609250
BCBS PIN
AZ
01
F46834
UPIN
AZ
01
Z78372
MEDICARE LEGACY GROUP #
AZ
01
Z78374
MEDICARE PROVIDER NUMBER
AZ
Enumeration date
10/10/2005
Last updated
05/02/2018
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