Gibbons, Kathleen K
Gibbons, Kathleen K is an individual health care provider with primary practice located at 6131 S Norcross Tucker Rd Ste 700, Norcross GA 30093-5536. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Gibbons, Kathleen K can be contacted via phone (678) 205-1959.Contact Information
Primary practice address
6131 S Norcross Tucker Rd Ste 700
Norcross GA 30093-5536
Phone: (678) 205-1959
Fax: (678) 205-2092
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 026530 | Georgia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 26530 | Georgia |
Profile Details
| NPI number | 1306865951 |
|---|---|
| LBN Legal business name | Gibbons, Kathleen K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Jun 13th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306865951 | NPPES |
| Georgia | MEDICAID | 000639834Z |
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