MEDICARE: LOREN CHRISTOPHER GIBSON

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
1	225100000X	Physical Therapist	PT8125	MS
2	225100000X	Physical Therapist	12273R	LA

General Provider Information

NPI Number	:	1548108210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOREN CHRISTOPHER GIBSON

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 MAGAZINE ST STE 3
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-1575
Country	:	US
Telephone Number	:	504-899-1437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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