Individual
DR. GERALD P GIBBONS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1620 HIGHWAY 315 BLVD STE 1, WILKES BARRE, PA 18702-7125
(570) 237-5444
Mailing address
1620 HIGHWAY 315 BLVD STE 1, WILKES BARRE, PA 18702-7125
(570) 237-5444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD020226E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006032010001
—
PA
01
—
001188
FIRST PRIORITY HEALTH
PA
01
—
020316
HIGHMARK BLUE SHIELD
PA
01
—
020338000
BLACK LUNG
PA
01
—
12039 E222
GEISINGER HEALTH PALN
PA
Enumeration date
07/08/2005
Last updated
06/15/2023
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