Organization
ROGER O. GIBSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER O. GIBSON M. D. (PRESIDENT)
(901) 751-0150
Entity
Organization
Contact information
Practice address
295 GERMANTOWN BEND CV, CORDOVA, TN 38018-7238
(901) 751-0150
(901) 695-2007
Mailing address
295 GERMANTOWN BEND CV, CORDOVA, TN 38018-7238
(901) 751-0150
(901) 695-2007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10277
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08560
STATE OF MISSISSIPPI BOARD OF LICENSE REGISTRATION
MS
Enumeration date
08/15/2007
Last updated
11/15/2024
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