Provider Demographics
NPI:1548834542
Name:GIBBON, KARLEE ELAINE (MD)
Entity type:Individual
Prefix:
First Name:KARLEE
Middle Name:ELAINE
Last Name:GIBBON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-1718
Mailing Address - Country:US
Mailing Address - Phone:423-968-3033
Mailing Address - Fax:423-968-3789
Practice Address - Street 1:2901 W STATE ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1718
Practice Address - Country:US
Practice Address - Phone:423-968-3033
Practice Address - Fax:423-968-3789
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL85973207V00000X
TN74702207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology