Individual
VANESSA R GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1265 UNION AVE, 2 SHORB TOWER, MEMPHIS, TN 38104
(901) 478-2211
(901) 478-2215
Mailing address
1211 UNION AVE STE 330, C/O PROVIDER ENROLLMENT, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
262935-1
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
39734
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
72174
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
262935-1
LICENSE
NY
01
—
39734
LICENSE
KY
Enumeration date
06/28/2007
Last updated
09/15/2025
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