DR. MARK TANNER GIBSON (NPI# 1225115561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225115561 |
| Entity Type | Individual |
| Full Name | DR. MARK TANNER GIBSON |
| Credential | PH.D. |
| Practice Address |
175 River View Dr Green River WY 82935-4811 |
| Practice Telephone | 3078723205 |
| Practice Fax Number | 3078723207 |
| Mailing Telephone | 3078723205 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
437 | WY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922434380 | Mark S. Gibson | Specialist/Technologist, Other | 2104 Blind Pond Ave, Lutz, FL 33549-5580 | 2013-09-17 |
| 1215211008 | Mark J. Gibson | Social Worker | 3610 American River Dr Ste 140, Sacramento, CA 95864-5919 | 2011-09-28 |
| 1922324276 | Mark Duane Gibson | Military Health Care Provider | Uss Louisville, Fpo, AP 96671-2404 | 2010-04-12 |
| 1437133444 | Mark C Gibson | Optometrist | 16306 E Lake Shore Dr, Austin, TX 78734-1132 | 2005-12-02 |
| 1720083439 | Mark William Gibson | Chiropractor | 7a Reich Street, Marsing, ID 83639-0252 | 2005-06-17 |
| 1619391802 | Mark Gibson | Orthotist | 3334 Capital Medical Blvd #400, Tallahassee, FL 32308-4470 | 2014-02-10 |
| 1417231465 | Mark W Gibson | Pharmacist | 1982 Eight Mile Rd, Cincinnati, OH 45255-2609 | 2011-10-07 |
| 1174845259 | Mark Anthony Gibson II | Physical Therapist | 1028 E Main St, Morehead, KY 40351-1328 | 2010-02-17 |
| 1710122106 | Mark Alan Gibson | Radiology | 545 Ne 47th Ave Ste 215, Portland, OR 97213-2237 | 2008-12-13 |
| 1780737437 | Mark S Gibson | Emergency Medicine | 3200 E Racine St, Janesville, WI 53546-2343 | 2007-01-18 |
| Street Address |
175 RIVER VIEW DR |
| City | GREEN RIVER |
| State | WY |
| Zip Code | 82935-4811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306376975 | Nicholas Henry Hastert | Physical Therapist | 330 Upland Way, Green River, WY 82935 | 2017-06-15 |
| 1174982045 | Marti Jo Sidwell | Case Management | 400 N 100 E, Suite 205, Green River, WY 82935 | 2016-02-19 |
| 1649428012 | Dana Kreusel | Physical Therapist | 520 Wilkes Dr Ste 17, Green River, WY 82935 | 2008-08-28 |
| 1902095375 | Peak Performance Sports Medicine Inc | Physical Therapist | 140 Commerce Drive, Green River, WY 82935 | 2007-10-22 |
| 1518159854 | Gordon Lee Balka | Preventive Medicine | General Chemical, 324 Allied Chemical Rd, Green River, WY 82935 | 2007-08-10 |
| 1720157316 | Daryl A Parker | Dentist | 190 E Flaming Gorge Way, Green River, WY 82935 | 2006-11-07 |
| 1891883203 | Darrin Lee Goyn | Physical Therapist | 541a East Flaming Gorge Way, Green River, WY 82935 | 2006-10-11 |
| 1740258466 | Michael Earl Nelson | Physical Therapist | 920 Upland Way, Green River, WY 82935 | 2006-03-09 |
| 1679702518 | Michael Ross Svejcar | Physical Therapist | 140 Commerce Drive, Green River, WY 82935 | 2009-07-14 |
| 1427215912 | Bryant Paul Birch | Dentist | 661 Uinta Dr, Green River, WY 82935 | 2008-05-21 |
| Find all providers in zip 82935 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598389827 | Julio Brionez | Psychologist | 1115 1/2 Steele Street, Laramie, WY 82070-4661 | 2020-06-02 |
| 1235356288 | Donald Howard Benson | Psychologist | 3437 Stagecoach Dr, Casper, WY 82604-5445 | 2007-04-19 |
| 1215928965 | Kim Knox Faulkner | Psychologist | 135 Pine Street, Suite B, Buffalo, WY 82834-2332 | 2005-11-02 |
| 1548656523 | Kelly Petrino, Psyd | Psychologist | 507 S 4th St, Laramie, WY 82070-3753 | 2015-04-07 |
| 1518206465 | Action Life Services, LLC | Psychologist | 963 Fort St, #4, Buffalo, WY 82834-2424 | 2013-02-12 |
| 1477707321 | Sheri J Fluellen | Psychologist | 719 E 17th St, Cheyenne, WY 82001-4711 | 2008-11-05 |
| 1184802175 | Cheryl A Godley | Psychologist | 1607 Cy Ave, Suite 302, Casper, WY 82604-3572 | 2008-02-01 |
| 1487709119 | Ronald L Sprinkle | Psychologist | 1277 N 15th St, Laramie, WY 82072-2343 | 2007-01-24 |
| 1760588271 | Kelly Lynne Pendley | Psychologist | 1277 N 15th St, Laramie, WY 82072-2343 | 2006-09-15 |
| 1073536801 | Kurt P Benson | Psychologist | 1898 Fort Road, Sheridan Va Medical Center, Sheridan, WY 82807 | 2006-07-25 |
| Find all providers with the same taxonomy | ||||
| City | GREEN RIVER |
| Zip Code | 82935 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.