| Gerald Gibbons Md Llc | |
|
1620 Highway 315 Blvd Ste 1 Wilkes Barre PA 18702-7125 | |
| (570) 237-5445 | |
| Not Available |
| Full Name | Gerald Gibbons Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1620 Highway 315 Blvd Ste 1, Wilkes Barre, Pennsylvania |
| Authorized Official Name and Position | Gerald Gibbons (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5702375445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerald Gibbons Md Llc 1620 Highway 315 Blvd Ste 1 Wilkes Barre PA 18702-7125 Ph: (570) 237-5445 | Gerald Gibbons Md Llc 1620 Highway 315 Blvd Ste 1 Wilkes Barre PA 18702-7125 Ph: (570) 237-5445 |
| NPI Number | 1336831940 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 05/23/2023 |
| Medicare PECOS PAC ID | 4183086242 |
|---|---|
| Medicare Enrollment ID | O20230822001107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336831940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gerald Gibbons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336147883 PECOS PAC ID: 6800975368 Enrollment ID: I20081013000291 |
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