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General NPI Number Information
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NPI Number | 1649490376
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Entity Type | Individual
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Provider Name | JOSEPH PATRICK GIBSON RPH
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Gender | Male
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 50 S BLUE ANGEL PKWY
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City | PENSACOLA
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State | FL
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Zip | 32506-6045
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Country | US
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Telephone | 850-457-3293
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Fax |
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Provider Business Mailing Address
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Address Line | 810 PANFERIO DR
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City | PENSACOLA BEACH
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State | FL
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Zip | 32561-2246
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Country | US
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Telephone | 850-932-1831
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS26203
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License Number State | FL
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