Provider Demographics
NPI:1417571365
Name:GIBSON, EMILY (DO)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15273 E PROGRESS PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-2281
Mailing Address - Country:US
Mailing Address - Phone:720-874-2490
Mailing Address - Fax:
Practice Address - Street 1:8401 S CHAMBERS RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-3276
Practice Address - Country:US
Practice Address - Phone:720-875-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0075200204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM