Healthcare Provider Details

I. General information

NPI: 1427058023
Provider Name (Legal Business Name): THOMAS A GIBBS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W CORK ST STE 100
WINCHESTER VA
22601-3870
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 320
WINCHESTER VA
22601-2889
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-0518
  • Fax: 540-536-0249
Mailing address:
  • Phone: 540-536-5100
  • Fax: 540-536-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number101058256
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: