Individual
DR. BRADLEY GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
290 BIG RUN RD, LEXINGTON, KY 40503
(859) 278-9513
Mailing address
290 BIG RUN RD, LEXINGTON, KY 40503-2903
(859) 278-9513
(859) 260-1003
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01078130A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
52184
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100310990
—
KY
Enumeration date
03/31/2013
Last updated
08/30/2019
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