| Doctor Name: | DR. KELVIN DEVANE GIPSON |
| NPI Number: | 1013022698 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M |
| License Number: | 1341 |
| Business Practice Address: | 2600 Hospital Dr Doctors Memorial Hospital/doctor's Specialty Clinc Bonifay, FL - 324254264 |
| Business Phone Number: | 8505478117 |
| Business Fax Number: | |
| Mailing Address: | Po Box 123, ARGYLE |
| State: | FL |
| Postal Code: | 324220123 |
| Phone Number: | 4074439784 |
| Fax Number: | |
| NPI Enumeration Date: | 08/21/2006 |
| NPI Last Update Date: | 08/31/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 1341 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |