# MICHELLE J. GIBSON, MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Kidz Care Klinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639352784
- **Authorized official:** DR. MICHELLE JEANETTE GIBSON MD (OWNER)
- **Authorized official phone:** (601) 364-2726

## Contact information

- **Practice address:** 5440 WATKINS DR, SUITE B, JACKSON, MS 39206-2034
- **Practice address phone:** (601) 364-2726
- **Practice address fax:** (601) 364-2731
- **Mailing address:** 5440 WATKINS DR, SUITE B, JACKSON, MS 39206-2034
- **Mailing address phone:** (601) 364-2726
- **Mailing address fax:** (601) 364-2731

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 15752 | MS | Yes |

## Other

- **Enumeration date:** 12/12/2007
- **Last updated:** 12/12/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00524231 | — | MS |