Gibson, Laura L
Gibson, Laura L is an individual health care provider with primary practice located at 55 Lake Ave N Department Of Infectious Disease, Worcester MA 01655-0002. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is her primary health care specialty. Gibson, Laura L can be contacted via phone (774) 441-8230.Contact Information
Primary practice address
55 Lake Ave N Department Of Infectious Disease
Worcester MA 01655-0002
Phone: (774) 441-8230
Fax: (508) 334-3428
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases | 2080P0208X | 157967 | Massachusetts |
Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 157967 | Massachusetts |
Profile Details
NPI number | 1801877535 |
---|---|
LBN Legal business name | Gibson, Laura L |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 9th, 2005 |
Last updated | Mar 3rd, 2021 - about 3 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 | 1801877535 | NPPES |
Massachusetts | MEDICAID | 110003152A |
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