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Individual

CHRISTI G GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
510 E OGLETHORPE HWY, HINESVILLE, GA 31313-2825
(912) 369-7546
(478) 274-8418
Mailing address
2400 BELLEVUE RD STE 21A, DUBLIN, GA 31021-2890
(478) 275-7202
(478) 274-8418

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005313
GA
363AM0700X
Medical Physician Assistant
005313
GA
363AS0400X
Surgical Physician Assistant
005313
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005313
STATE LICENSE
GA
Enumeration date
07/29/2008
Last updated
03/11/2015
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