Individual
DR. MARK C. GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1111 GRIFFIN AVE, SUITE 1A, EASTMAN, GA 31023-9101
(478) 448-4416
(478) 448-4423
Mailing address
1111 GRIFFIN AVE, SUITE 1A, EASTMAN, GA 31023-9101
(478) 448-4416
(478) 448-4423
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
054569
GA
208800000X
Urology Physician
2008-01266
NC
Other
Enumeration date
07/21/2005
Last updated
07/14/2011
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