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NPI Code Detail

MEDICARE: DR. GREGORY D GIBBONS MD

MEDICARE: DR. GREGORY D GIBBONS MD
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
1207RG0100XGastroenterology Physician35044971OH

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 : 1861486102
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY D GIBBONS MD
Provider Business Mailing Address
First Line : 3400 OLENTANGY RIVER RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1523
Country : US
Telephone Number : 614-754-5500
Fax Number : 614-457-9519
Provider Business Practice Location Address
First Line : 3400 OLENTANGY RIVER RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1523
Country : US
Telephone Number : 614-754-5500
Fax Number : 614-457-9519
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2005
Last Update Date : 08/15/2014

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