Individual
JAMES GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3015 S RIDGE DR, SPRINGFIELD, MO 65809-3729
(417) 887-2342
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R1C87
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106983
BLUE CROSS/BLUE SHIELD
—
05
—
109513001
—
AR
05
—
201677408
—
MO
Enumeration date
06/13/2006
Last updated
05/17/2022
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