Healthcare Provider Details

I. General information

NPI: 1477634442
Provider Name (Legal Business Name): LARRY M GIBBS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 9TH AVE SW
BESSEMER AL
35022-4527
US

IV. Provider business mailing address

PO BOX 830674
BIRMINGHAM AL
35283-0674
US

V. Phone/Fax

Practice location:
  • Phone: 205-313-5262
  • Fax: 205-313-5245
Mailing address:
  • Phone: 205-313-5262
  • Fax: 205-313-5245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number12214
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: