Individual
DR. BRUCE N GIBBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-2100
(423) 844-2120
Mailing address
PO BOX 11724, KNOXVILLE, TN 37939-1724
(423) 844-2100
(423) 844-2120
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101250860
VA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
25099
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3867436
—
TN
Enumeration date
04/05/2006
Last updated
07/07/2021
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