Individual
STEPHEN P GIBERT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18 RIVERBEND DR SW, SUITE 120, ROME, GA 30161-6013
(706) 378-1202
(706) 378-1204
Mailing address
PO BOX 80883, ATHENS, GA 30608-0883
(706) 549-8114
(706) 549-7558
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
22773
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
22773
SC
208VP0014X
Interventional Pain Medicine Physician
Primary
075624
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227739
—
SC
Enumeration date
08/29/2006
Last updated
03/21/2016
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