Individual
DR. GARY R GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 WINDSOR DR, CORTLAND, OH 44410-2705
(330) 637-0356
(330) 637-0361
Mailing address
310 WINDSOR DR, CORTLAND, OH 44410-2705
(330) 637-0356
(330) 637-0361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35048883
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000147036
ANTHEM
OH
05
—
0631865
—
OH
01
—
4122159
AETNA
OH
Enumeration date
07/18/2005
Last updated
01/06/2011
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