| Doctor Name: | RUSSELL WAYNE GIBSON |
| NPI Number: | 1083642789 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 228355 |
| Business Practice Address: | 423 E 23rd St New York, NY - 100105011 |
| Business Phone Number: | 2126867500 |
| Business Fax Number: | |
| Mailing Address: | 245 E 21st St, #2b NEW YORK |
| State: | NY |
| Postal Code: | 100106410 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 228355 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |