Individual
DR. JOHN CHARLES GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6330 E 75TH ST STE 110, INDIANAPOLIS, IN 46250-2717
(317) 588-7130
(317) 813-1346
Mailing address
6330 E 75TH ST STE 110, INDIANAPOLIS, IN 46250-2717
(317) 588-7130
(317) 813-1346
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
02006812A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300064032
—
IN
Enumeration date
06/06/2018
Last updated
10/06/2022
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