Individual
JOSEPH N GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-8500
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
35-045535
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224272
UNISON
OH
01
—
000000539499
ANTHEM
OH
01
—
110239345
RAILROAD MEDICARE
OH
05
—
2100149
—
OH
01
—
2115384
AETNA
OH
01
—
363555
WELLCARE
OH
01
—
741822
BUCKEYE
OH
01
—
P00445626
RAILROAD MEDICARE
OH
Enumeration date
07/19/2006
Last updated
06/29/2011
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