Michael Robert Gibbs, DC
Individual provider Active NPI Chiropractor · Princeton, MN
NPI 1053483370 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053483370
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1206 (MN)
- Practice address
- 501 4TH St S
Princeton, MN 55371-2031 - Phone
- (763) 389-4411
- Fax
- (763) 389-4412
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Princeton Chiropractic Office PA | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1206 | MN | Yes |
Addresses
Primary practice location
501 4TH St S
Princeton, MN 55371-2031
Mailing address
501 4TH St S
Princeton, MN 55371-2031
Phone (763) 389-4411
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02B10GI | Other | MN | BLUE CROSS PROVIDER NUMBE |
Other providers in Princeton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.