Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 04-32563 | KS |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 115621 | MO |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 38422 | TN |
NPI | 1114984705 |
---|---|
Provider Name | Dr. Charles W Gibbs |
First Address | Kansas City, MO 64141-1851 |
Second Address | Kansas City, KS 66160-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 13/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3893560 | (05) | TN |
H23443 | (02) |