Individual
KENNETH ALAN GIBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
975 RYLAND ST STE 100, RENO, NV 89502-1669
(775) 982-5000
(775) 982-3900
Mailing address
850 HARVARD WAY, RENO, NV 89502-2055
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
14284
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010F362410
BCBSM
MI
01
—
11276898
CAQH
—
05
—
1184684227
—
NV
05
—
1577652
—
MI
Enumeration date
03/24/2006
Last updated
01/22/2019
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