Individual
PAUL GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1118 N MULDOON RD, ANCHORAGE, AK 99504
(888) 227-3312
Mailing address
1118 N MULDOON RD, ANCHORAGE, AK 99504-6109
(888) 227-3312
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1069
AK
363AM0700X
Medical Physician Assistant
PA10004583
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1060779
NCCPA
WA
01
—
PA10004583
WA PA CERT
WA
01
—
PA1069
AK LICENSE
AK
Enumeration date
02/13/2007
Last updated
03/07/2023
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