Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 053743 | GA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 684 | SC |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 9401197 | NC |
NPI | 1992867634 |
---|---|
Provider Name | Dr. Thomas Whitney Gibson |
First Address | Greenville, SC 29605-4255 |
Second Address | Greenville, SC 29605-4255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 16/03/2010 |