Individual
THOMAS J GIBSON
Active
Individual
THOMAS J GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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