Individual
MATTHEW EUGENE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10060 REGENCY CIR, OMAHA, NE 68114-3732
(402) 354-1325
(402) 354-1301
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
29196
NE
208000000X
Pediatrics Physician
6987
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10225837400
—
NE
05
—
1366881187
—
IA
05
—
47068731742
—
NE
Enumeration date
06/14/2013
Last updated
07/12/2016
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