Individual
GEORGE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3670 PARKER BLVD STE 101, PUEBLO, CO 81008-2207
(719) 564-1544
(719) 924-1593
Mailing address
3670 PARKER BLVD STE 101, PUEBLO, CO 81008-2207
(719) 562-2900
(719) 924-1593
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
32323
CO
207RI0011X
Interventional Cardiology Physician
Primary
32323
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01323237
—
CO
01
—
P00997269
RAILROAD MEDICARE
CO
Enumeration date
05/19/2006
Last updated
06/03/2021
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