Individual
RUSSELL EUGENE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
107 GLIDEPATH WAY, LEBANON, TN 37090-4133
(615) 449-5771
Mailing address
PO BOX 1172, LEBANON, TN 37088-1172
(615) 449-5771
Taxonomy
Speciality
Code
Description
License number
State
2080S0012X
Pediatric Sleep Medicine Physician
Primary
41991
TN
2080S0012X
Pediatric Sleep Medicine Physician
4301087799
MI
Other
Enumeration date
01/13/2007
Last updated
08/01/2022
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