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Contact Information

MICHELLE J GIBSON, MD
5440 WATKINS DR
SUITE B
JACKSON, MS39206-2034
 Phone: 601-364-2726
 Fax: 601-364-2731
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MICHELLE J GIBSON · (Female)

NPI # 1659366854
Status Active
Credentials MD
Entity Individual
Enumeration date 09/13/2005
Last updated 08/12/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # 15752
  • MS Medicaid 00119640
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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