Provider Demographics
NPI:1194882423
Name:GIBBS, ROBERT C (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:GIBBS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BOB
Other - Middle Name:
Other - Last Name:GIBBS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1512 ATKINSON RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-1612
Mailing Address - Country:US
Mailing Address - Phone:609-350-8085
Mailing Address - Fax:856-692-1225
Practice Address - Street 1:1512 ATKINSON RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-1612
Practice Address - Country:US
Practice Address - Phone:609-350-8085
Practice Address - Fax:856-692-1225
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00474800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6824102Medicaid
T29581Medicare UPIN
NJ6824102Medicaid