Individual
MITCHELL S GIBBONS
Active
Individual
MITCHELL S GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
04-48713
KS
207N00000X
Dermatology Physician
R-11831
IA
207R00000X
Internal Medicine Physician
R-11831
IA
Other
Enumeration date
05/20/2020
Last updated
06/24/2024
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