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Individual

DR. MICHAEL G GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4515 SOUTHLAKE PKWY STE 200, HOOVER, AL 35244-3319
(205) 313-7246
(205) 939-1911
Mailing address
4515 SOUTHLAKE PKWY, SUITE 200, HOOVER, AL 35244-3319
(205) 313-7246
(205) 939-1911

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
17424
AL
207LP2900X
Pain Medicine (Anesthesiology) Physician
17424
AL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
17424
AL
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
17424
AL
208VP0000X
Pain Medicine Physician
17424
AL
208VP0014X
Interventional Pain Medicine Physician
Primary
17424
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0510 25521
BLUECROSSBLUESHIELD AL
AL
01
167883900
US DEPT OF LABOR
01
20-00232
UNITED HEALTHCARE
AL
05
529502690
AL
Enumeration date
01/16/2007
Last updated
10/31/2017
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