GIBSON COMMUNITY HOSPITAL ASSOCIATION NPI 1093448011

NPI Information

NPI: 1093448011
Provider Name: GIBSON COMMUNITY HOSPITAL ASSOCIATION

Doing Business As: GIBSON RECOVERY OPTIMIZING WELLNESS

Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
10 DOCTORS PARK
GIBSON CITY, IL
ZIP 60936
Phone: (217) 784-4251
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GIBSON COMMUNITY HOSPITAL ASSOCIATION is an addiction medicine family medicine in Gibson City, IL. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. GIBSON COMMUNITY HOSPITAL ASSOCIATION NPI is 1093448011. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Gibson Recovery Optimizing Wellness.

The provider's business location address is:

10 DOCTORS PARK
GIBSON CITY, IL
ZIP 60936-004
Phone: (217) 784-4251

The provider's authorized official is Matthew Ertel .
The authorized official title is Chief Financial Officer and has the following contact phone number (217) 784-2601.

The enumeration date for this NPI number is 7/7/2022 and was last updated on 8/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0401X	Family Medicine	Addiction Medicine			Yes

What is NPI?

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This page was last updated on: 5/5/2024

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