Provider Demographics
NPI:1861591596
Name:GIBBINS, GEORGE MARSHALL (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MARSHALL
Last Name:GIBBINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:MARSHALL
Other - Last Name:GIBBINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1029 CHRISTINE AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5709
Mailing Address - Country:US
Mailing Address - Phone:256-237-0371
Mailing Address - Fax:256-236-4181
Practice Address - Street 1:1029 CHRISTINE AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5709
Practice Address - Country:US
Practice Address - Phone:256-237-0371
Practice Address - Fax:256-236-4181
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00005414207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000002270Medicaid
0132340001Medicare NSC
AL000002270Medicaid
AL000002270Medicare PIN