Doctor Name: | KIRWIN GREGORY GIBBS |
NPI Number: | 1043279748 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 206592-1 |
Business Practice Address: | Cortland Memorial Hospital 153 Homer Ave Cortland, NY - 13045 |
Business Phone Number: | 3157822620 |
Business Fax Number: | 3157884980 |
Mailing Address: | 1116 Arsenal St, Suite 504 WATERTOWN |
State: | NY |
Postal Code: | 136012229 |
Phone Number: | 3157822620 |
Fax Number: | 3157884980 |
NPI Enumeration Date: | 03/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0203X |
License Number: | 206592-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Therapeutic Radiology |
Taxonomy Definition: |