Jonathan David Gibson

Individual provider Active NPI Other Technician · Essexville, MI

NPI 1407204993 · NPPES record last updated May 25, 2016

Key facts

NPI
1407204993
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
43 Jean CT
Essexville, MI 48732-9407
Phone
(989) 402-8851
NPI assigned
May 25, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

43 Jean CT
Essexville, MI 48732-9407

Mailing address

43 Jean CT
Essexville, MI 48732-9407
Phone (989) 402-8851

Other providers in Essexville, MI

All providers in Essexville, MI · Other Technician in Michigan

Sources for this page

Verify at the official NPI Registry.