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DR. BRIAN THOMAS MCKIBBEN M.D. NPI 1609828557


NPI Information

NPI: 1609828557
Provider Name: DR. BRIAN THOMAS MCKIBBEN, M.D.
Classification: Colon & Rectal Surgery - 208C00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1515 MAY ST
JACKSONVILLE, FL
ZIP 32204
Phone: (904) 353-5921
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DR. Brian Thomas Mckibben, M.D. is a colon rectal surgery in Jacksonville, FL. The provider is a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. DR. Brian Thomas Mckibben, M.D. NPI is 1609828557. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1515 MAY ST
JACKSONVILLE, FL
ZIP 32204-007
Phone: (904) 353-5921

The NPI 1609828557 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 7/8/2007.


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
1208C00000XColon & Rectal Surgery40936FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
107162MEDICARE ID-TYPE UNSPECIFIEDFLORIDA
251868MEDICARE UPINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.