Provider Demographics
NPI:1558372862
Name:GIBBS, JOANNA CHER (MD)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:CHER
Last Name:GIBBS
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 1:57 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-4836
Mailing Address - Country:US
Mailing Address - Phone:931-250-5433
Mailing Address - Fax:931-250-5434
Practice Address - Street 1:57 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4836
Practice Address - Country:US
Practice Address - Phone:931-250-5433
Practice Address - Fax:931-250-5434
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD32165207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4013840OtherBLUE CROSS
TN3861257Medicaid
110223950OtherRAILROAD MEDICARE
TN4013840OtherBLUE CROSS
TN3861259Medicare ID - Type Unspecified
TN3861257Medicaid