Individual
LAURA GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-1000
(573) 882-4438
(573) 884-9992
Mailing address
400 N KEENE ST, SOUTH PAVILION, COLUMBIA, MO 65201-6626
(573) 882-4438
(573) 884-9992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2016022785
MO
208000000X
Pediatrics Physician
2016022785
MO
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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