Individual
DR. DWAYNE L GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 W MAPLE ST, FARMINGTON, NM 87401-6113
(505) 609-6300
(505) 609-6301
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 324-2098
(505) 324-6454
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
91-205
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53885
—
NM
Enumeration date
02/26/2007
Last updated
11/08/2018
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