Individual ProviderMitchell L GibsonChiropractorChiropractic ProvidersPractice Address3801 Johnson Mill Blvd Ste A&B, Fayetteville, AR 72704-2002(479) 332-4100(479) 443-0800PECOS EnrollmentBased on the most recent information from CMS, provider Mitchell L Gibson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1336288414Provider TypeIndividualFull NameGibson, Mitchell LTitleDr.CredentialDCGenderMaleSole ProprietorYesEnumeration Date2/6/2007Last Updated12/2/2021Contact InformationPractice LocationPractice Address3801 Johnson Mill Blvd Ste A&B, Fayetteville, AR 72704-2002Phone(479) 332-4100Fax(479) 332-4092Mailing LocationMailing Address1583 Main Dr, Fayetteville, AR 72704-5214Phone(479) 443-0800Fax(479) 443-5538Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicense1698Arkansas