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Individual

DUANE DUKE GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
250 S. MAIN STREET, EUREKA, NV 89316
(775) 237-5313
(775) 237-5073
Mailing address
142 S. 50 E., PO BOX 865, COALVILLE, UT 84017
(435) 336-4403

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4922994-1206
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA1005
PA LICENSE
NV
Enumeration date
10/11/2006
Last updated
05/31/2016
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