Provider Demographics
NPI:1871696575
Name:GIBSON, PATRICIA LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LYNNE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:LYNNE
Other - Last Name:DUGGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:25 BASS DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4693
Mailing Address - Country:US
Mailing Address - Phone:501-615-5935
Mailing Address - Fax:
Practice Address - Street 1:11001 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4316
Practice Address - Country:US
Practice Address - Phone:501-615-5935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-62412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry