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DR. LEE L GIBSON D.O.

>> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1780608778

Individual Registrant:
DR. LEE L GIBSON D.O.
Gender: M
Sole Proprietor

Location and contact information for practice:
190 SW NATURES CT  FORT WHITE, FL 32038-2357 US
Tel: 386-961-4728  Fax: --

Contact information for business:
PO BOX 118  FORT WHITE, FL 32038-0118 US
Tel: 386-497-1240  Fax: --

Registration Information:
NPI: 1780608778
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine
FLOS5067

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
35654900FL05




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