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Contact Information

ANTONIO L GIBSON SR
594 GERONIMO DR
GREENFIELD, IN46140-9375
 Phone: 317-413-8137
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vehicle Modifications

171WV0202X
 

Driver

172A00000X
Indicates primary specialty

NPI Profile & details for ANTONIO L GIBSON SR · (Male)

NPI Number 1508624016
Status Active
Credentials
Entity Individual
Enumeration date 03/08/2024
Last updated 03/14/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 202303151673406
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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