Individual
DR. ROBERT D GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00003294
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023548
—
WA
01
—
410045005
RAIL ROAD MEDICARE
WA
01
—
410045007
RAIL ROAD MEDICARE
ID
01
—
410045008
RAIL ROAD MEDICARE
OR
01
—
410047409
RAIL ROAD MEDICARE
MT
Enumeration date
08/24/2006
Last updated
11/19/2020
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