Randel C. Gibson, DO PSC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02027 Issued in KY

Legal business name

RANDEL C. GIBSON, DO PSC

Practice address

1029 Medical Center Cir
Suite 200
Mayfield, KY 42066-1189

Phone

(270) 251-4545

Fax

(270) 251-4546

NPI assigned

Feb 6, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Randel C Gibson, D.O.

Title

Physician/Owner

Phone

(270) 251-4545

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1457590945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 MEDICAL CENTER CIR",
            "address_2": "SUITE 200",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661189",
            "telephone_number": "270-251-4545",
            "fax_number": "270-251-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 MEDICAL CENTER CIR",
            "address_2": "SUITE 200",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661189",
            "telephone_number": "270-251-4545",
            "fax_number": "270-251-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDEL C. GIBSON, DO PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "RANDEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "270-251-4545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "02027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Mayfield, KY
• Providers in Mayfield, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.