Gustaf Gibson, O.D

NPI 1215917307 · on the registry since 2006 · sole proprietor

Practice

Address: 145 W Cache Valley Blvd
Logan, UT 84341
Phone: (435) 787-9273
Fax: (435) 787-9275
Organisation at this address: Sams West Inc
Sam'S Club Optical
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: Optometrist
152W00000X
Also registered as: Optometrist
Licence states on file: OR, UT
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2023-06-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah