Individual
DR. LAWRENCE LARAY GIPSON
Active
Individual
DR. LAWRENCE LARAY GIPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD020526E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009070000001
—
PA
01
—
1011634
GATEWAY
PA
01
—
1478243
UMWA
PA
01
—
180012945
RAILROAD MEDICARE
PA
01
—
60198
UNISON
PA
01
—
77999
AETNA US HEALTH CARE
PA
01
—
P019692
CHAMPUS
PA
Enumeration date
06/21/2005
Last updated
09/07/2011
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