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NPI Code Detail

MEDICARE: DR. JOHNNY M GIBBS M.D.

MEDICARE: DR. JOHNNY M GIBBS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianMD.46414AL
2207X00000XOrthopaedic Surgery PhysicianBP10024844TX
3207X00000XOrthopaedic Surgery PhysicianME109657FL
4207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianME109657FL
5207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianMD.46414AL

General Provider Information

NPI Number : 1528257730
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHNNY M GIBBS M.D.
Provider Business Mailing Address
First Line : 5018 CAHABA RIVER RD
Second Line :
City : VESTAVIA
State : AL
Zip : 35243-2317
Country : US
Telephone Number : 205-397-5200
Fax Number : 205-203-9858
Provider Business Practice Location Address
First Line : 5018 CAHABA RIVER RD
Second Line :
City : VESTAVIA
State : AL
Zip : 35243-2317
Country : US
Telephone Number : 205-397-5200
Fax Number : 205-203-9858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2007
Last Update Date : 12/06/2023

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