Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN013381 | GA |
Y | 213EG0000X | General Practice | DN013381 | GA |
NPI | 1003922907 |
---|---|
Provider Name | Dr. Frank E Gibbons |
First Address | West Warrick, RI 02893 |
Second Address | West Warrick, RI 02893 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 21/07/2010 |