Individual
JOHN R GIBSON
Active
Individual
JOHN R GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13867
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0050576
BLUE CROSS BLUE SHIELD
TN
01
—
110054563
RR MEDICARE
TN
05
—
3194593
—
TN
01
—
4082150
AETNA
TN
Enumeration date
06/19/2006
Last updated
10/17/2014
Update your record
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