Individual
MICHAEL J GIPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
903 MISSISSIPPI DR, TUPELO, MS 38804-0928
(662) 377-4652
(662) 377-4656
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19300
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02394
MEDICARE GROUP
MS
Enumeration date
07/22/2006
Last updated
08/10/2007
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