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Individual

DR. LEE L GIBSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
190 SW NATURES CT, FORT WHITE, FL 32038-2357
(386) 961-4728
Mailing address
PO BOX 118, FORT WHITE, FL 32038-0118
(386) 497-1240

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS5067
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
35654900
FL
Enumeration date
07/26/2006
Last updated
01/14/2008
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