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Individual

MR. BARRY CHARLES GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
100 BREWSTER BLVD, NH CAMP LEJEUNE, CAMP LEJEUNE, NC 28542
(910) 451-0579
Mailing address
101 PENQUIN PL, HAMPSTEAD, NC 28443-3746
(910) 330-3709

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
08/28/2008
Last updated
08/28/2008
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