| NPI | 1457641011 |
|---|---|
| Doing Business As | WILLIE B GIBSON MD PC |
| Entity Type | Organization |
| Authorized Contact | LEE ANN ODOM President Shared Services 947-522-3326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2021-10-21 |