Individual
DR. KEVIN J GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HIGH ST, SUITE B4, BUFFALO, NY 14203-1126
(716) 218-1000
(716) 650-2691
Mailing address
7923 E QUAKER RD, ORCHARD PARK, NY 14127-2016
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
177872
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010063202
UNIVERA INSURANCE
NY
01
—
000524440002
BLUE CROSS OF WNY
NY
05
—
01432113
—
NY
01
—
0605580
INDEPENDENT HEALTH INS
NY
01
—
CNS177872
WORKERS COMPENSATION
NY
Enumeration date
03/17/2006
Last updated
02/27/2013
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