Organization
J. DAVID GIBEAULT, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J DAVID GIBEAULT MD (PRESIDENT)
(520) 577-1200
Entity
Organization
Contact information
Practice address
3100 N CAMPBELL AVE, SUITE 102, TUCSON, AZ 85719-2315
(520) 577-1200
(520) 577-1559
Mailing address
PO BOX 30370, TUCSON, AZ 85751-0370
(520) 722-0777
(520) 290-9713
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
13121
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
249202
—
AZ
01
—
AZ0337040
BCBSAZ
AZ
Enumeration date
01/22/2007
Last updated
10/22/2007
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