Individual
DR. MICHAEL GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-3435
Mailing address
1808 W BELTLINE HWY, MADISON, WI 53713-2334
(608) 250-1497
(608) 250-1384
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
73815-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356737464
—
WI
Enumeration date
04/15/2015
Last updated
12/18/2020
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