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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

MICHAEL J GIBSON, P.A.-C.
100 MCDOUGAL DR
HOLDENVILLE, OK74848-2822
 Phone: 405-379-4202
 Fax: 405-379-4340
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MICHAEL J GIBSON · (Male)

NPI Number 1487681201
Credentials P.A.-C.
Entity Individual
Enumeration date 06/27/2006
Last updated 10/17/2011 - About 5 years ago
Sole proprietor 1 No
Identifiers
OK License # 199
OK Medicaid 100848080A
Medicare (Unspecified) 245531101
Medicare UPIN R84266
Other 0784740001 DMERC REGION C
Other P00266954 PALMETTO GBA RAILROAD MC
Hospital affiliation(s) n/a
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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