Individual
DR. VETRA ANETE GIPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3601 SW 160TH AVE, SUITE 250, MIRAMAR, FL 33027-6308
(305) 866-9951
(877) 284-8933
Mailing address
4480 S COBB DR SE STE H, BOX 323, SMYRNA, GA 30080-6984
(404) 805-5535
(866) 935-5995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
47858
TN
208200000X
Plastic Surgery Physician
050518
GA
208200000X
Plastic Surgery Physician
Primary
47858
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00963102A
—
GA
01
—
24BCBWK
MEDICARE ID
GA
Enumeration date
07/27/2005
Last updated
09/16/2024
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