Gibson, Bradford W
Gibson, Bradford W is an individual health care provider with primary practice located at 1200 Northside Forsyth Dr , Cumming GA 30041-7659. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Gibson, Bradford W can be contacted via phone (770) 844-3200.Contact Information
Primary practice address
1200 Northside Forsyth Dr
Cumming GA 30041-7659
Phone: (770) 844-3200
Fax: (404) 851-6325
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | R1182 | Kentucky |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 061433 | Georgia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 061433 | Georgia |
Profile Details
| NPI number | 1922296458 |
|---|---|
| LBN Legal business name | Gibson, Bradford W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2007 |
| Last updated | Jan 19th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922296458 | NPPES |
| Georgia | MEDICAID | 725131782A | |
| Georgia | MEDICAID | 7100026740 |
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