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General NPI Number Information
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NPI Number | 1770509713
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Entity Type | Individual
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Provider Name | SHIRLEY K. GIBSON MD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 606 BURKESVILLE RD
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City | ALBANY
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State | KY
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Zip | 42602-1612
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Country | US
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Telephone | 606-387-0675
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Fax | 606-387-3149
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Provider Business Mailing Address
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Address Line | PO BOX 1080
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City | BURKESVILLE
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State | KY
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Zip | 42717-1080
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Country | US
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Telephone | 270-864-1472
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Fax | 270-864-1693
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 38599
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 38599
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 38599
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 38599
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License Number State | KY
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