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DR. LEE L GIBSON D.O.
>> Emergency Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1780608778
Individual Registrant:DR. LEE L GIBSON D.O.
Gender: M
Sole Proprietor
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: --
Tel: 386-961-4728 Fax: --
Contact information for business:
PO BOX 118 FORT WHITE, FL 32038-0118 US
Tel: 386-497-1240 Fax: --
Tel: 386-497-1240 Fax: --
Registration Information:
NPI: 1780608778
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207P00000X | Allopathic & Osteopathic Physicians Emergency Medicine | FL | OS5067 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 35654900 | FL | 05 |
