Individual
RENAH T GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3517 W OWEN K GARRIOTT RD STE 4, ENID, OK 73703-4953
(580) 233-5553
(580) 233-5641
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(580) 233-5553
(580) 233-5641
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5563
OK
Other
Enumeration date
04/22/2013
Last updated
02/13/2020
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