| Doctor Name: | DR. WILLIAM BURLIN GIBSON |
| NPI Number: | 1043388234 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.M.D. |
| License Number: | 7055 |
| Business Practice Address: | 200 Medical Center Dr Suite 2-o Hazard, KY - 417019466 |
| Business Phone Number: | 6064870088 |
| Business Fax Number: | 6064871849 |
| Mailing Address: | 10447 Dryhill Road, CONFLUENCE |
| State: | KY |
| Postal Code: | 41749 |
| Phone Number: | 6066722075 |
| Fax Number: | 6064871849 |
| NPI Enumeration Date: | 12/04/2006 |
| NPI Last Update Date: | 06/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 7055 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |