Individual
DR. MARY J GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 MED TECH PKWY STE 240, JOHNSON CITY, TN 37604-2641
(423) 341-6436
Mailing address
217 SHADOWOOD DR, JOHNSON CITY, TN 37604-1128
(423) 341-6436
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19131
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3054016
—
TN
Enumeration date
06/16/2005
Last updated
01/03/2024
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