Organization
LARRY GIBSON, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY GIBSON M.D. (OWNER/PRESIDENT)
(423) 954-9556
Entity
Organization
Contact information
Practice address
2051 HAMILL ROAD, #B, HIXSON, TN 37343
(423) 877-1212
Mailing address
1709 VALLEY FORGE DRIVE, HIXSON, TN 37343
(423) 954-9556
(423) 954-9505
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3074845
BLUECROSS/BLUESHIELD
TN
05
—
3181502
—
TN
Enumeration date
10/02/2006
Last updated
08/22/2020
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