Individual
THOMAS J GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4000 W WOODWAY DR, MUNCIE, IN 47304-4264
(765) 289-5006
(765) 213-4951
Mailing address
4000 W WOODWAY DR, MUNCIE, IN 47304-4264
(765) 289-5006
(765) 213-4951
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01027054
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000880440
ANTHEM BCBS
IN
05
—
100344330B
—
IN
01
—
IN1953004
MEDICARE
IN
Enumeration date
01/17/2007
Last updated
03/17/2021
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