Provider Demographics
NPI:1548238561
Name:GIBSON, FLOYD BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:BRIAN
Last Name:GIBSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:704-295-3468
Practice Address - Street 1:6035 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3256
Practice Address - Country:US
Practice Address - Phone:704-295-3000
Practice Address - Fax:704-295-3468
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31948207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC141030OtherCOVENTRY HEALTHCARE
NC4209215OtherAETNA
NC8935419Medicaid
SC20095446OtherSELECT HEALTH OF SC
NC35419OtherBCBS
NC77828OtherMEDCOST
NC376560OtherMAMSI
NC26018OtherPARTNERS
SC773878OtherWELLCARE
SCN31948Medicaid
SC000000296461OtherUNISON HEALTH PLAN OF SC
NC33492OtherWELLPATH
SC85369OtherCHC CARES OF SC
NC1041755OtherUNITED HEALTHCARE
E15367Medicare UPIN
2196289AMedicare ID - Type Unspecified
NC8935419Medicaid