Provider Demographics
NPI:1922097419
Name:GIBSON, JAMES ARTHUR (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ARTHUR
Last Name:GIBSON
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 BELLA WAY
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-2402
Mailing Address - Country:US
Mailing Address - Phone:662-231-3191
Mailing Address - Fax:
Practice Address - Street 1:1ST RTBN MCRD ERR
Practice Address - Street 2:BUILDING 592
Practice Address - City:PARRIS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29905-6100
Practice Address - Country:US
Practice Address - Phone:843-228-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist