Doctor Name: | DR. TYLER DOUGLASS GIBB |
NPI Number: | 1255311288 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD00034512 |
Business Practice Address: | 700 Lincoln St Suite 100 Kelso, WA - 986261057 |
Business Phone Number: | 3604255131 |
Business Fax Number: | 3604255509 |
Mailing Address: | 700 Lincoln St, Suite 100 KELSO |
State: | WA |
Postal Code: | 986261057 |
Phone Number: | 3604255131 |
Fax Number: | 3604255509 |
NPI Enumeration Date: | 01/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0204X |
License Number: | MD00034512 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Vascular & Interventional Radiology |
Taxonomy Definition: | A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |