MEDICARE: DR. JANET GIBSON DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS7353	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831129360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET GIBSON DO

Provider Business Mailing Address
First Line	:	1626 N PLAZA DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5323
Country	:	US
Telephone Number	:	850-513-0067
Fax Number	:	850-561-6670

Provider Business Practice Location Address
First Line	:	1626 N PLAZA DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5323
Country	:	US
Telephone Number	:	850-513-0067
Fax Number	:	850-561-6670

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	02/23/2012

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Directions to “ DR. JANET GIBSON DO” Practice Location

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