| Jenner Gibson, MD | |
|
25a June St, Sanford, ME 04073-2642 | |
| (207) 490-7998 | |
| Not Available |
| Full Name | Jenner Gibson |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 25a June St, Sanford, Maine |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902286131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD27892 (Maine) | Primary |
| Entity Name | Mainehealth |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790265502 PECOS PAC ID: 7517860588 Enrollment ID: O20040701000166 |
| Mailing Address | Practice Location Address |
|---|---|
| Jenner Gibson, MD 25a June St, Sanford, ME 04073-2642 Ph: (207) 490-7998 | Jenner Gibson, MD 25a June St, Sanford, ME 04073-2642 Ph: (207) 490-7998 |
Timothy A Theobald, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 25a June St Ste 111, Sanford, ME 04073 Phone: 207-490-7998 | |
Mary L Callison, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 10 Goodall Drive, Sanford, ME 04073 Phone: 207-490-7790 | |
Amanda Reavis Gibson, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 25a June St Ste 111, Sanford, ME 04073 Phone: 207-490-7998 | |
Steven J Schneider, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 25a June St, Sanford, ME 04073 Phone: 207-324-8311 Fax: 207-324-7899 | |
Melissa Ifantides, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 25a June St, Suite 101, Sanford, ME 04073 Phone: 207-490-7998 | |
William F Frank, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 14 Winter St, Sanford, ME 04073 Phone: 207-324-3226 Fax: 207-324-4088 | |
Mr. Richard S Tockman, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 25a June St, Sanford, ME 04073 Phone: 207-324-8311 Fax: 207-324-7899 |