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Contact Information

GUSTAF I GIBSON, OD
145 W CACHE VALLEY BLVD
LOGAN, UT84341-8473
 Phone: 435-787-9273
 Fax: 435-787-9275
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for GUSTAF I GIBSON · (Male)

NPI Number 1215917307
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 01/17/2006
Last updated 06/15/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # 2994T
  • UT License # 5823517-9934
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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