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NPI Code Detail

MEDICARE: FRANK GIBASE M.D.

MEDICARE: FRANK GIBASE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician040075GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194718494
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANK GIBASE M.D.
Provider Business Mailing Address
First Line : PO BOX 1303
Second Line :
City : VIDALIA
State : GA
Zip : 30475-1303
Country : US
Telephone Number : 912-538-5359
Fax Number : 912-538-5228
Provider Business Practice Location Address
First Line : 1 MEADOWS PKWY
Second Line :
City : VIDALIA
State : GA
Zip : 30474-8759
Country : US
Telephone Number : 912-538-5359
Fax Number : 912-538-5228
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 08/27/2015

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