Healthcare Provider Details

I. General information

NPI: 1588143275
Provider Name (Legal Business Name): GIBSON GENERAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 SHERMAN DR
PRINCETON IN
47670-1043
US

IV. Provider business mailing address

PO BOX 1197
EVANSVILLE IN
47706-1197
US

V. Phone/Fax

Practice location:
  • Phone: 812-385-9420
  • Fax: 812-385-9426
Mailing address:
  • Phone: 812-385-9420
  • Fax: 812-385-9426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LOIS MORGAN
Title or Position: VICE PRESIDENT & CNO
Credential:
Phone: 812-385-9237