Individual
DR. JOHN HEYL GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
190 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6946
(336) 277-2200
(336) 277-2210
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 277-2200
(336) 277-2210
Taxonomy
Speciality
Code
Description
License number
State
2084H0002X
Hospice and Palliative Medicine (Psychiatry & Neurology) Physician
36445
SC
2084N0400X
Neurology Physician
Primary
2006-00136
NC
2084N0400X
Neurology Physician
36445
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00605571
RR MEDICARE
NC
Enumeration date
08/05/2006
Last updated
10/25/2020
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