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General NPI Number Information
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NPI Number | 1902923048
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Entity Type | Individual
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Provider Name | MARK GIBBS MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1650 CROOKED OAK DR SUITE 200
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City | LANCASTER
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State | PA
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Zip | 17601-4278
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Country | US
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Telephone | 717-569-3279
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Fax | 717-569-2187
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Provider Business Mailing Address
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Address Line | 1650 CROOKED OAK DR SUITE 200
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City | LANCASTER
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State | PA
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Zip | 17601-4278
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Country | US
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Telephone | 717-569-3279
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Fax | 717-569-2187
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD437299
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License Number State | PA
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