Provider Demographics
NPI:1992867634
Name:GIBSON, THOMAS WHITNEY (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WHITNEY
Last Name:GIBSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:950 W FARIS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4255
Mailing Address - Country:US
Mailing Address - Phone:864-271-3444
Mailing Address - Fax:864-255-7877
Practice Address - Street 1:950 W FARIS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4255
Practice Address - Country:US
Practice Address - Phone:864-271-3444
Practice Address - Fax:864-255-7877
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA053743207XP3100X
SC684207XP3100X
NC9401197207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery