Individual
DR. JENNIFER DIANE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
325 N STATE OF FRANKLIN RD, GROUND FL, JOHNSON CITY, TN 37604
(423) 439-7320
(423) 439-7343
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-7320
(423) 439-7343
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD48687
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528648
—
TN
Enumeration date
06/25/2009
Last updated
01/17/2024
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