Individual
GREGORY LEE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1901 MELBA DR, DOTHAN, AL 36301-3017
(334) 794-6611
Mailing address
1901 MELBA DR, DOTHAN, AL 36301-3017
(941) 920-3244
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1265
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2010
Last updated
04/29/2012
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