| Jeff Gibson Do | |
|
307a S Locust St Nowata OK 74048-3622 | |
| (918) 273-2761 | |
| (918) 273-2753 |
| Full Name | Jeff Gibson Do |
|---|---|
| Speciality | Family Medicine |
| Location | 307a S Locust St, Nowata, Oklahoma |
| Authorized Official Name and Position | Jeffrey Gibson (OWNER) |
| Authorized Official Contact | 9182732761 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeff Gibson Do 307a S Locust St Nowata OK 74048-3622 Ph: (918) 273-2761 | Jeff Gibson Do 307a S Locust St Nowata OK 74048-3622 Ph: (918) 273-2761 |
| NPI Number | 1164555058 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1254498017 |
|---|---|
| Medicare Enrollment ID | O20090323000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164555058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3261 (Oklahoma) | Primary |
| Provider Name | Jeffrey L Gibson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306807011 PECOS PAC ID: 1052475928 Enrollment ID: I20090323000048 |
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