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Individual

GORDON F GIBBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
115 E RIVERWALK, UNIT 200, PUEBLO, CO 81003-3308
(719) 542-7891
Mailing address
PO BOX 7702, LOVELAND, CO 80537-0702
(719) 543-8346
(719) 545-1829

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
43153
MN
2085R0202X
Diagnostic Radiology Physician
45004
CO
2085R0204X
Vascular & Interventional Radiology Physician
35524
NE
2085R0204X
Vascular & Interventional Radiology Physician
Primary
45004
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08179263
CO
05
852927200
MN
Enumeration date
02/06/2006
Last updated
04/06/2023
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