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General NPI Number Information
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NPI Number | 1417929373
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Entity Type | Individual
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Provider Name | GORDON F GIBBS M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 115 E RIVERWALK UNIT 200
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City | PUEBLO
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State | CO
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Zip | 81003-3308
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Country | US
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Telephone | 719-542-7891
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7702
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City | LOVELAND
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State | CO
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Zip | 80537-0702
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Country | US
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Telephone | 719-543-8346
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Fax | 719-545-1829
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 45004
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 43153
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 35524
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 45004
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License Number State | CO
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