Individual
PETER DESMOND GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 E OAK AVE, FLAGSTAFF, AZ 86001
(928) 779-7880
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
55699
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363405
—
AZ
Enumeration date
04/02/2012
Last updated
06/18/2019
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