Individual
CRYSTAL D GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
101 TOWN AND COUNTRY LN, SUITE 100, HAZARD, KY 41701-9524
(606) 439-1300
(606) 439-1400
Mailing address
200 MEDICAL CENTER DR STE 1A, HAZARD, KY 41701-9477
(606) 439-5220
(606) 439-5221
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA807
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95004271
—
KY
Enumeration date
05/23/2006
Last updated
11/15/2024
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