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Individual

CLAYTON GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
311 S 15TH ST, COSHOCTON, OH 43812-1873
(740) 622-1200
Mailing address
PO BOX 57, WEST LAFAYETTE, OH 43845-0057

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35085233
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2524665
OH
Enumeration date
07/13/2006
Last updated
07/08/2007
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