Individual
MR. STEPHEN LAVON GIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6005 PARK AVE, SUITE 400, MEMPHIS, TN 38119-5215
(901) 767-9500
(907) 767-7324
Mailing address
6005 PARK AVE, SUITE 400, MEMPHIS, TN 38119-5215
(901) 767-9500
(907) 767-7324
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD14982
TN
208VP0000X
Pain Medicine Physician
Primary
0000014982
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125345900
US DEPT OF LABOR
TN
01
—
40796
BLUE CROSS OF TN
TN
01
—
4226549
AETNA
—
Enumeration date
10/26/2006
Last updated
01/10/2017
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