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Individual
KERMIT DONALD GIBSON
Active
Individual
KERMIT DONALD GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02080
KY
208D00000X
General Practice Physician
Primary
02080
KY
261QP2300X
Primary Care Clinic/Center
02080
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112617
FED BLACK LUNG
—
01
—
1270152
UMWA FUNDS
—
05
—
64020803
—
KY
Enumeration date
01/26/2007
Last updated
10/31/2025
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