Individual
KEVIN A GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46277-2317
(317) 887-7000
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7912
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01064682
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000557377
ANTHEM
IN
05
—
200894230
—
IN
01
—
Q00416539
RAILROAD MEDICARE
IN
Enumeration date
03/27/2008
Last updated
02/13/2023
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