Organization
ROGER O. GIBSON MD PC
Active
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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