Individual
CHARLES GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2425 ZERO ST, FORT SMITH, AR 72901-8663
(479) 649-5900
(479) 649-6724
Mailing address
2425 ZERO ST, FORT SMITH, AR 72901-8663
(479) 649-5900
(479) 649-6724
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2069
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041012
NATIONAL VISION ASSOCIATI
—
01
—
07225
SPECTERA
—
01
—
1454016
OPTICHOICE
—
01
—
26766
MEDICAL EYE SERVICES
—
01
—
38855
AVESIS
—
01
—
47678
DAVIS VISION
—
01
—
47859
ARKANSAS BCBS
—
01
—
56908
SUPERIOR VISION PLAN
—
01
—
710739595001
OKLAHOMA BCBS
—
01
—
923045
BLOCK VISION
—
Enumeration date
11/09/2006
Last updated
07/08/2007
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