| Kathleen Gibson, MD | |
|
Medical Center Blvd, Winston Salem, NC 27157-0001 | |
| (336) 716-2255 | |
| (336) 716-7595 |
| Full Name | Kathleen Gibson |
|---|---|
| Gender | Female |
| Speciality | Pathology - Anatomic Pathology |
| Location | Medical Center Blvd, Winston Salem, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922082981 | NPI | - | NPPES |
| 891169V | Medicaid | NC | |
| 2003690000 | Medicaid | WV | |
| 46204 | Other | PARTNERS | |
| 1169V | Other | BCBS | |
| B3049 | Other | MEDCOST | |
| 6608167 | Medicaid | VA | |
| 7572345 | Other | AETNA | |
| Q0161C | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0101X | Pathology - Anatomic Pathology | 96-01616 (North Carolina) | Primary |
| 207ZC0500X | Pathology - Cytopathology | 96-01616 (North Carolina) | Secondary |
| Entity Name | Wake Forest University Health Sciences |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436 |
| Entity Name | Blue Ridge Pathology Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568425262 PECOS PAC ID: 2466447446 Enrollment ID: O20040419000818 |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Gibson, MD Po Box 344, Winston Salem, NC 27102-0344 Ph: (336) 716-2255 | Kathleen Gibson, MD Medical Center Blvd, Winston Salem, NC 27157-0001 Ph: (336) 716-2255 |
Stacey O'neill, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-4195 Fax: 336-716-3202 | |
Dr. Kimberly Ann Stogner, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: Medical Center Blvd, Department Of Pathology, Winston Salem, NC 27157 Phone: 336-716-2673 | |
Dr. Herbert Miles Schiller, M.D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 2851 Kensington Rd, Winston Salem, NC 27106 Phone: 336-724-9607 | |
Graham Parks, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2255 Fax: 336-716-7595 | |
Gregory Jay Pomper, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2255 Fax: 336-716-6368 | |
Dr. Cyrus Koresh Manavi, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2255 Fax: 336-716-7595 | |
Rebecca Montez Steele, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2115 |