Individual
STEPHANIE L GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 MEDICAL CENTER DR, NEWTON, KS 67114-8780
(316) 283-2700
Mailing address
PO BOX 308, NEWTON, KS 67114-0308
(316) 283-2700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28096
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054904
BCBS
KS
01
—
100237
HPK
KS
05
—
100334990A
—
KS
01
—
11522
PHS
KS
01
—
12149528
MULTIPLAN
KS
01
—
16991
COVENTRY
KS
Enumeration date
07/03/2006
Last updated
06/03/2015
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