Individual
MR. SCOTT WILLIAM GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
315 W DALTON AVE STE B, COEUR D ALENE, ID 83815-8600
(208) 209-2066
(208) 209-2076
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 209-2066
(208) 209-2076
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-301
ID
363AM0700X
Medical Physician Assistant
PA-301
ID
Other
Enumeration date
05/16/2006
Last updated
11/02/2020
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