Dr. Gustaf Isaac Gibson, O.D.
Optometrist in Logan, UT. Individual provider (NPI-1).
NPI number1215917307
StatusActive
Last updated in NPPESJun 15, 2023
Details
- NPI
- 1215917307
- Entity type
- Individual (NPI-1)
- Name
- Dr. Gustaf Isaac Gibson
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 17, 2006
- Certification date
- Jun 15, 2023
- Last updated
- Jun 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 5823517-9934 | UT | Yes |
| 152W00000X | Optometrist | 2994T | OR |
Practice location
145 W Cache Valley BlvdLogan, UT 84341-8473
Phone 435-787-9273 · Fax 435-787-9275
Mailing address
435 W 1140 NLogan, UT 84341-6994
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Optometrist providers in Logan, UT
- Aeg Utah Professional INCNPI 1154212777
- Richard Dallin BoardmanNPI 1346764511
- Bradley Budge, ODNPI 1851708846
- Budge Vision LLCNPI 1093573727
- Michael Wayne Cole, O.D.NPI 1689970667
- Jeffrey L Cromwell, O.D.NPI 1801902333
- Kevin Mark Ellsworth, O.D.NPI 1669457024
- Eye Care For You LLCNPI 1619112398
- Eye Care For You P.C.NPI 1154506012
- Eye Pros Of Logan LLCNPI 1043702046
All 24 Optometrist providers in Logan · All 1,815 providers in Logan
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.