Individual
DR. THOMAS W GIBBS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
857 AUTO MALL RD, BLOOMINGTON, IN 47440-5447
(812) 332-2204
(812) 332-9095
Mailing address
857 AUTO MALL RD, BLOOMINGTON, IN 47440-5447
(812) 332-2204
(812) 332-9095
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12006707A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000325306
ANTHEM BCBS
—
Enumeration date
06/13/2006
Last updated
07/08/2007
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