Individual
DR. ERIC JON RAINEY GIBSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
1003 GRAND AVENUE, WEST DES MOINES, IA 50265-3502
(515) 267-1003
(515) 267-0100
Mailing address
1003 GRAND AVENUE, WEST DES MOINES, IA 50265-3502
(515) 267-1003
(515) 267-0100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
00966
IA
103T00000X
Psychologist
HSP00445
IA
103TC0700X
Clinical Psychologist
00966
IA
103TC0700X
Clinical Psychologist
HSP00445
IA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
00966
IA
103TC2200X
Clinical Child & Adolescent Psychologist
HSP00445
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1045898
—
IA
01
—
36432
BLUE SHIELD
IA
01
—
IA0134
JOHN DEERE HC
IA
Enumeration date
03/14/2006
Last updated
09/11/2025
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