Organization
GIBSON FAMILY MEDICAL CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN EDGAR HALL (OWNER)
(731) 855-3585
Entity
Organization
Contact information
Practice address
700 HOSPITAL DR, TRENTON, TN 38382-3319
(731) 855-3585
(731) 855-9745
Mailing address
700 HOSPITAL DR, TRENTON, TN 38382-3319
(731) 855-3585
(731) 855-9745
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28290
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3147103
BLUE CROSS BLUE SHIELD
TN
05
—
3811292
—
TN
Enumeration date
02/07/2013
Last updated
02/07/2013
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