Individual
MRS. CHRISTIE HUSKEY GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-AC
Contact information
Practice address
380 HOSPITAL DR, SUITE 410, MACON, GA 31217
(478) 746-5644
(478) 745-4849
Mailing address
PO BOX 2564, MACON, GA 31203-2565
(478) 746-5644
(478) 745-4849
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
5907
GA
367H00000X
Anesthesiologist Assistant
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003100272A
—
GA
05
—
003100272B
—
GA
05
—
003100272C
—
GA
05
—
003100272D
—
GA
05
—
003100272E
—
GA
01
—
01777944
AMERIGROUP
GA
01
—
580628385
TRICARE
GA
01
—
714937
WELLCARE
GA
01
—
P01142251
RAILROAD MEDICARE
GA
Enumeration date
06/09/2010
Last updated
06/04/2013
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