Healthcare Provider Details

I. General information

NPI: 1992721138
Provider Name (Legal Business Name): HUGO M. GIBSON, D.C., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NW KILLARNEY LN
LEES SUMMIT MO
64081-1606
US

IV. Provider business mailing address

1801 NW KILLARNEY LN
LEES SUMMIT MO
64081-1606
US

V. Phone/Fax

Practice location:
  • Phone: 816-525-4086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. HUGO MICHAEL GIBSON
Title or Position: PRESIDENT
Credential:
Phone: 816-525-4086