Individual
GARY E GIBLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2145 CAJA DEL ORO GRANT RD, SANTA FE, NM 87507-3279
(505) 438-3195
(505) 424-5699
Mailing address
2145 CAJA DEL ORO GRANT RD, SANTA FE, NM 87507-3279
(505) 438-3195
(505) 424-5699
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
95243
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H4541
—
NM
Enumeration date
10/13/2005
Last updated
10/19/2011
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