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NPI Code Detail

MEDICARE: J SCOTT GIBSON MD PC

MEDICARE: J SCOTT GIBSON MD PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology PhysicianMD14370OR

General Provider Information

NPI Number : 1508001074
Entity Type Code : Organization
Provider Name (Legal Business Name) : J SCOTT GIBSON MD PC
Provider Business Mailing Address
First Line : 851 NE BAKER ST STE 3
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-4991
Country : US
Telephone Number : 503-472-0888
Fax Number : 503-434-7246
Provider Business Practice Location Address
First Line : 851 NE BAKER ST STE 3
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-4991
Country : US
Telephone Number : 503-472-0888
Fax Number : 503-434-7246
Authorized Official
Title or Position : PRESIDENT
Name : J SCOTT GIBSON
Credential : MD
Telephone Number : 503-472-0888
Provider Enumeration Date : 12/11/2008
Last Update Date : 12/11/2008

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