Individual
MRS. GWENDOLYN OCTAVIA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 S MAIN ST, CHATHAM, VA 24531-5436
(434) 432-4471
(434) 432-3555
Mailing address
705 MAIN ST, DANVILLE, VA 24541-1803
(434) 791-3630
(434) 791-4088
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101-057103
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101-057103
STATE LICENSE
VA
01
—
179099
ANTHEM - HENRICO COUNTY
—
01
—
234086
ANTHEM - HANOVER COUNTY
—
01
—
288630
SOUTHERN HEALTH
—
01
—
3325244
CIGNA
—
05
—
6730043
—
VA
Enumeration date
08/18/2006
Last updated
05/12/2026
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