Individual
DR. JEFFREY EUGENE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
855 W 6TH S, MOUNTAIN HOME, ID 83647-3335
(208) 587-2020
(208) 587-3349
Mailing address
855 W 6TH S, MOUNTAIN HOME, ID 83647-3335
(208) 587-2020
(208) 587-3349
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP995
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806081500
—
ID
Enumeration date
04/20/2006
Last updated
04/04/2017
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