Gibson, Brian Clayton

Gibson, Brian Clayton is an individual health care provider with primary practice located at 415 S 28Th Ave , Hattiesburg MS 39401-7246. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is his primary health care specialty. Gibson, Brian Clayton can be contacted via phone (601) 268-5800.

Contact Information

Primary practice address
415 S 28Th Ave Hattiesburg MS 39401-7246
Phone: (601) 268-5800
Fax: (601) 261-3530
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R872628 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X R872628 Mississippi

Profile Details

NPI number 1427337765
LBN Legal business name Gibson, Brian Clayton
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2011
Last updated Jan 30th, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427337765 NPPES
Mississippi Other 9695764 AETNA
Mississippi Other P01013953 AETNA
Mississippi MEDICAID 09853301 AETNA

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