Individual
DR. WILLIAM BURLIN GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
200 MEDICAL CENTER DR, SUITE 2-O, HAZARD, KY 41701-9466
(606) 487-0088
(606) 487-1849
Mailing address
10447 DRYHILL ROAD, CONFLUENCE, KY 41749
(606) 672-2075
(606) 487-1849
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7055
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7055
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
7055
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000236923
BLUE CROSS BLUE SHILED KY
KY
01
—
238396
BLUE CROSS BLUE SHIELD VA
VA
01
—
343574
UNITED CONCORDIA INS
—
05
—
60070554
—
KY
05
—
64342546
—
KY
Enumeration date
12/04/2006
Last updated
06/16/2014
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