| NPI | 1316418288 |
|---|---|
| Doing Business As | GIBSON FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | WILLIAM LEE GIBSON Manager 318-918-0058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2020-10-26 |