Gibson, Michelle J
Gibson, Michelle J is an sole proprietor health care provider with primary practice located at 5440 Watkins Dr Suite B, Jackson MS 39206-2034. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Gibson, Michelle J can be contacted via phone (601) 364-2726.Contact Information
Primary practice address
5440 Watkins Dr Suite B
Jackson MS 39206-2034
Phone: (601) 364-2726
Fax: (601) 364-2731
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 15752 | Mississippi |
Profile Details
| NPI number | 1659366854 |
|---|---|
| LBN Legal business name | Gibson, Michelle J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 13th, 2005 |
| Last updated | Aug 12th, 2011 - about 15 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 | 1659366854 | NPPES |
| Mississippi | MEDICAID | 00119640 |
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