Individual
LATIFFANY TENNILLE GORDON GIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 NORTH ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 214-9907
Mailing address
100 NORTH ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 214-9907
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
77371
GA
208600000X
Surgery Physician
Primary
MD464797
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2010
Last updated
05/22/2020
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