Provider Demographics
NPI:1588764690
Name:GIBBS, THOMAS ARTHUR (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ARTHUR
Last Name:GIBBS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:624 MARKET AVE N
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-1017
Mailing Address - Country:US
Mailing Address - Phone:330-493-4553
Mailing Address - Fax:330-493-3761
Practice Address - Street 1:200 E STATE ST FL 3
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4936
Practice Address - Country:US
Practice Address - Phone:330-821-8503
Practice Address - Fax:330-627-0088
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.004094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0653681Medicaid