Provider Demographics
NPI:1568569721
Name:GIBB, REED THOMAS (OD)
Entity Type:Individual
Prefix:
First Name:REED
Middle Name:THOMAS
Last Name:GIBB
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 S MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-5518
Mailing Address - Country:US
Mailing Address - Phone:435-634-0420
Mailing Address - Fax:435-634-5409
Practice Address - Street 1:754 S MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-5518
Practice Address - Country:US
Practice Address - Phone:435-634-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5346530-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist