Individual
MR. THOMAS MITCHELL GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HEALTH AID
Contact information
Practice address
40 MAINSTREET, PAUL MARTIN GUNDERSEN MEMORIAL CLINIC, NELSON LAGOON, AK 99751
(907) 989-2202
(907) 989-2245
Mailing address
3380 C STREET, EASTERN ALEUTIAN TRIBES, SUITE 100, ANCHORAGE, AK 99503
(907) 277-1440
(907) 277-1446
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
06-891-IV
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06-891-IV
ALASKA COMMUNITY HEALTH AID CERTIFICATION
AK
Enumeration date
06/05/2015
Last updated
06/05/2015
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