Individual
RANDAL BOYD GIBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
1650121205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-00362
UNITED HEALTHCARE
UT
01
—
107006654103
IHC
UT
01
—
233116
ALTIUS
UT
01
—
36245
DMBA
UT
01
—
81445
PEHP
UT
01
—
870281028RG2
EMIA
UT
01
—
P00215615
PALMETTO
UT
Enumeration date
09/02/2006
Last updated
07/08/2020
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