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Individual

DR. MICHAEL JAMES GIBSON JUBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
376 W 10TH AVE, COLUMBUS, OH 43210-1280
(614) 366-5130
Mailing address
10651 E ST, CORPUS CHRISTI, TX 78419-5130
(361) 961-6000

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0102206811
VA
207P00000X
Emergency Medicine Physician
58.034842
OH
207R00000X
Internal Medicine Physician
58.034842
OH
208D00000X
General Practice Physician
Primary
0102206811
VA

Other

Enumeration date
04/25/2020
Last updated
04/07/2025
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