Organization
WENDY SOWELL GIBSON OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDY GIBSON OD (OWNER)
(270) 527-0951
Entity
Organization
Contact information
Practice address
1512 MAIN ST, BENTON, KY 42025-1607
(270) 527-0951
(270) 527-1316
Mailing address
1512 MAIN ST, BENTON, KY 42025-1607
(270) 527-0951
(270) 527-1316
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
911DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77009116
—
KY
Enumeration date
06/12/2007
Last updated
11/14/2013
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