Dr. Mark C. Gibbons, D.O.
Urology in Eastman, GA. Individual provider (NPI-1).
NPI number1346249257
StatusActive
Last updated in NPPESJul 14, 2011
Details
- NPI
- 1346249257
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mark C. Gibbons
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 21, 2005
- Last updated
- Jul 14, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | 054569 | GA | Yes |
| 208800000X | Urology | 2008-01266 | NC |
Practice location
1111 Griffin AveSuite 1a
Eastman, GA 31023-9101
Phone 478-448-4416 · Fax 478-448-4423
Mailing address
1111 Griffin AveSuite 1a
Eastman, GA 31023-9101
Phone 478-448-4416 · Fax 478-448-4423
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