Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Theodore Dwayne Gibson I, CST/CFA

Individual provider Surgical Technologist · NPI 1639152473

Mr. Theodore Dwayne Gibson I, CST/CFA is a Surgical Technologist in Hobart, Indiana. Registered with an NPI since 2005.

In the registry since
2005
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Practice location Address checks out

1500 S Lake Park Ave
Hobart, IN 46342-6638
Phone: (219) 947-6425
Fax: (219) 947-6424
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Technologist (primary) Taxonomy 246ZS0410X

Record details

NPI number1639152473
Entity typeIndividual (Type 1)
GenderMale
Credentials CST/CFA
Sole proprietorNo
NPI enumeratedNovember 25, 2005
Last updated in NPPESJuly 13, 2026