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1043388234 NPI number — WILLIAM BURLIN GIBSON D.M.D.

NPI Number: 1043388234
Health Care Provider/Practitioner: WILLIAM BURLIN GIBSON D.M.D.

Information about “1043388234” NPI (WILLIAM BURLIN GIBSON D.M.D.) exists in 1043388234 in HTML format HTML  |  1043388234 in plain Text format TXT  |  1043388234 in PDF (Portable Document Format) PDF  |  1043388234 in an XML format XML  formats.

NPI Number : 1043388234 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1043388234",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GIBSON",
    "FirstName": "WILLIAM",
    "MiddleName": "BURLIN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10447 DRYHILL ROAD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CONFLUENCE",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "41749",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "606-672-2075",
    "MailingAddressFaxNumber": "606-487-1849",
    "FirstLinePracticeLocationAddress": "200 MEDICAL CENTER DR",
    "SecondLinePracticeLocationAddress": "SUITE 2-O",
    "PracticeLocationAddressCityName": "HAZARD",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "41701-9466",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "606-487-0088",
    "PracticeLocationAddressFaxNumber": "606-487-1849",
    "EnumerationDate": "12/04/2006",
    "LastUpdateDate": "06/16/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "204E00000X",
          "TaxonomyName": "Oral & Maxillofacial Surgery (D.M.D.)",
          "LicenseNumber": "7055",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223S0112X",
          "TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
          "LicenseNumber": "7055",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "7055",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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