Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 07000385A | IN |
Y | 222Z00000X | Podiatrist | 07000385A | IN |
NPI | 1013955491 |
---|---|
Provider Name | Dr. Lynn Arthur Gibney |
First Address | Speedway, IN 46224-6818 |
Second Address | Speedway, IN 46224-6818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 21/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100061860 | (05) | IN |
T34534 | (02) | IN |