Individual
JEVAUGHN GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
109 FINNEGAN CT, MYRTLE BEACH, SC 29579-4205
(843) 903-0949
Mailing address
109 FINNEGAN CT, MYRTLE BEACH, SC 29579-4205
(843) 903-0949
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2549
SC
152W00000X
Optometrist
OPT.0004171
CO
152W00000X
Optometrist
Primary
OPT003727
GA
Other
Enumeration date
05/05/2025
Last updated
06/23/2026
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