Individual
DR. JAMES J GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 S NEW BALLAS RD DEPT OF, SAINT LOUIS, MO 63141-8221
(314) 251-6000
(636) 386-7679
Mailing address
339 CONSORT DR, BALLWIN, MO 63011-4439
(636) 386-9224
(636) 386-7679
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R9D30
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
R9D30
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202056826
—
MO
Enumeration date
06/16/2005
Last updated
02/15/2023
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