Organization
ROBERT J GIBSON, M.D. LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J GIBSON M.D. (DR/OWNER)
(703) 360-3008
Entity
Organization
Contact information
Practice address
8101 HINSON FARM RD, SUITE 118, ALEXANDRIA, VA 22306-3404
(703) 360-3008
(703) 360-6204
Mailing address
8101 HINSON FARM RD, SUITE 118, ALEXANDRIA, VA 22306-3404
(703) 360-3008
(703) 360-6204
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101030484
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
409633
MEDICARE PTAN
VA
05
—
5680701
—
VA
Enumeration date
07/26/2010
Last updated
07/26/2010
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