Organization
MICHELLE J. GIBSON, MD PLLC
Active
Other names
The Kidz Care Klinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE JEANETTE GIBSON MD (OWNER)
(601) 364-2726
Entity
Organization
Contact information
Practice address
5440 WATKINS DR, SUITE B, JACKSON, MS 39206-2034
(601) 364-2726
(601) 364-2731
Mailing address
5440 WATKINS DR, SUITE B, JACKSON, MS 39206-2034
(601) 364-2726
(601) 364-2731
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
15752
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00524231
—
MS
Enumeration date
12/12/2007
Last updated
12/12/2007
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