Individual
DR. JOHN M GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2310
(360) 414-2000
Mailing address
PO BOX 11510, WESTMINSTER, CA 92685-1510
(866) 883-5375
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD00047671
WA
207P00000X
Emergency Medicine Physician
Primary
MD183368
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274621
—
OR
05
—
8489247
—
WA
Enumeration date
07/19/2007
Last updated
03/25/2024
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