| Doctor Name: | WILLIAM G GIBSON |
| NPI Number: | 1003218876 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-C |
| License Number: | COA.17029-NP |
| Business Practice Address: | 9500 Euclid Ave Mail Code H18 Cleveland, OH - 441950001 |
| Business Phone Number: | 2164440733 |
| Business Fax Number: | 2166365387 |
| Mailing Address: | 9500 Euclid Ave, Mail Code H18 CLEVELAND |
| State: | OH |
| Postal Code: | 441950001 |
| Phone Number: | 2164440733 |
| Fax Number: | 2166365387 |
| NPI Enumeration Date: | 09/23/2014 |
| NPI Last Update Date: | 02/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | COA.17029-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |