Individual
DR. GILSON JOHN KINGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2901 MAPLEWOOD AVE, WINSTON SALEM, NC 27103
(336) 765-8620
(336) 768-6236
Mailing address
2901 MAPLEWOOD AVE, WINSTON SALEM, NC 27103
(336) 765-8620
(336) 768-6236
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
200001205450
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49032
BCBS
NC
01
—
8798
PARTNERS
NC
05
—
8949032
—
NC
01
—
B0941
MECOST
NC
01
—
P00024584
RAILROAD MEDICARE
—
Enumeration date
06/09/2006
Last updated
12/17/2012
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