Dr. Michael B Ibach
Gastroenterologist
1375 Roberts Dr Ste 204
Jacksonville Beach
, Florida 32250-3210
Dr. Michael B Ibach
Gastroenterologist
1375 Roberts Dr Ste 204
Jacksonville Beach
, Florida 32250-3210
(904) 265-4807
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About
Features
Specialties
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Dr. Michael B Ibach
- 4800 Belfort Rd
- Jacksonville, FL
- Zip : 32256-6004
- Fax : (904) 265-4807
- Phone : (904) 398-3262
Second Address
- Dr. Michael B Ibach
- 1375 Roberts Dr Ste 204
- Jacksonville Beach, FL
- Zip : 32250-3210
- Fax : (904) 241-0065
- Phone : (904) 247-0056
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RG0100X | Gastroenterologist | 26687 | TN |
| Y | 207RG0100X | Gastroenterologist | ME67895 | FL |
National Provider Identifier
| NPI | 1053362723 |
|---|---|
| Provider Name | Dr. Michael B Ibach |
| First Address | Jacksonville, FL 32256-6004 |
| Second Address | Jacksonville Beach, FL 32250-3210 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/05/2006 |
| Last Update Date | 24/05/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 003230300 | (05) | FL |
| 14AW4 | BCBS (01) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.