Organization
GREGORY A GIBSON M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY GIBSON (OFFICE MANAGER)
(904) 824-3777
Entity
Organization
Contact information
Practice address
301 HEALTH PARK BLVD STE 322, SAINT AUGUSTINE, FL 32086-5771
(904) 824-3777
(904) 824-6050
Mailing address
301 HEALTH PARK BLVD STE 322, SAINT AUGUSTINE, FL 32086-5771
(904) 824-3777
(904) 824-6050
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME0060293
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12553
BCBS
FL
Enumeration date
01/10/2008
Last updated
01/30/2008
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