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NPI Code Detail

MEDICARE: DOUGLAS S GIBSON LPT

MEDICARE:   DOUGLAS S GIBSON  LPT
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
1225100000XPhysical Therapist6314NC

General Provider Information

NPI Number : 1912987793
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS S GIBSON LPT
Provider Business Mailing Address
First Line : 2808 MCLAMB PL
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-1600
Country : US
Telephone Number : 919-736-2157
Fax Number : 919-580-0424
Provider Business Practice Location Address
First Line : 2808 MCLAMB PL
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-1600
Country : US
Telephone Number : 919-736-2157
Fax Number : 919-580-0424
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 07/08/2007

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1285699108 — GOLDSBORO ORTHOPAEDIC ASSOCIATES, PA
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Directions to “ DOUGLAS S GIBSON LPT” Practice Location

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