Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 35046911 | OH |
NPI | 1205817939 |
---|---|
Provider Name | Dr. Garth D Phibbs |
First Address | Toledo, OH 43606-3856 |
Second Address | Toledo, OH 43606-3856 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 09/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0470682 | (05) | OH |
104752550 | (05) | MI |