Individual
HARRIS GIBSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 GEORGE P HASSETT DR, MEDFORD, MA 02155-3201
(781) 391-0050
(781) 391-1767
Mailing address
101 GEORGE P HASSETT DR, MEDFORD, MA 02155-3201
(781) 391-0050
(781) 391-1767
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
29474
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0131571
—
MA
Enumeration date
07/06/2005
Last updated
10/04/2011
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