Individual
M KELSEY GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D8231
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00EC95
BLUE CROSS BLUE SHIELD
TX
05
—
0329625-01
—
TX
01
—
4355846
AETNA
TX
Enumeration date
09/04/2006
Last updated
12/14/2010
Update your record
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