Provider Demographics
NPI:1659402592
Name:GIBBONS, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:GIBBONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WAINWRIGHT RD
Mailing Address - Street 2:UNIT #106
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2300
Mailing Address - Country:US
Mailing Address - Phone:617-729-9299
Mailing Address - Fax:
Practice Address - Street 1:7 WAINWRIGHT RD
Practice Address - Street 2:UNIT #106
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-2300
Practice Address - Country:US
Practice Address - Phone:617-729-9299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25947207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery