Provider Demographics
NPI:1285087247
Name:GIBSON, LAUREN MARIE (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BAY ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5181
Mailing Address - Country:US
Mailing Address - Phone:256-543-2894
Mailing Address - Fax:256-543-8185
Practice Address - Street 1:501 BAY ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5179
Practice Address - Country:US
Practice Address - Phone:256-543-2894
Practice Address - Fax:256-543-8185
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL38201208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics