Provider Demographics
NPI:1467230987
Name:CALFEE, GIBSON DEANE (PA-C)
Entity Type:Individual
Prefix:
First Name:GIBSON
Middle Name:DEANE
Last Name:CALFEE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 GREEN ACRES RD
Mailing Address - Street 2:
Mailing Address - City:MAYNARDVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37807-3943
Mailing Address - Country:US
Mailing Address - Phone:865-661-3108
Mailing Address - Fax:
Practice Address - Street 1:1610 TAZEWELL RD STE 302
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37879-3648
Practice Address - Country:US
Practice Address - Phone:423-626-0374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant