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Individual

TIMOTHY SCOTT GIBBONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
310 2ND ST S, NAMPA, ID 83651-3765
(208) 467-1361
(208) 467-9008
Mailing address
310 2ND ST S, NAMPA, ID 83651-3765
(208) 467-1361
(208) 467-9008

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
2999
TN
152W00000X
Optometrist
727
NV
152W00000X
Optometrist
Primary
ODP-100526
ID

Other

Enumeration date
07/05/2011
Last updated
11/11/2024
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