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General NPI Number Information
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NPI Number | 1629120761
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Entity Type | Individual
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Provider Name | JILL GIBSON MD
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1715 IRON HORSE DR STE 100
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City | LONGMONT
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State | CO
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Zip | 80501-9617
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Country | US
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Telephone | 720-494-4700
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Fax | 720-494-4706
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 719-463-5600
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Fax | 719-538-2990
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | DR.0049086
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License Number State | CO
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