Individual
DR. KENNETH WAYNE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
124 E MAIN ST, HULBERT, OK 74441-8902
(918) 772-3390
(918) 772-1233
Mailing address
PO BOX 751, HULBERT, OK 74441-8902
(918) 772-3390
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2170
OK
207Q00000X
Family Medicine Physician
OS9095
FL
Other
Enumeration date
08/11/2006
Last updated
06/04/2019
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