Provider Demographics
NPI:1922366863
Name:GIBBS, SHELLY LORN (MD)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:LORN
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 1:9601 BAPTIST HEALTH DR STE 1200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6334
Mailing Address - Country:US
Mailing Address - Phone:501-664-4131
Mailing Address - Fax:501-975-1798
Practice Address - Street 1:9601 BAPTIST HEALTH DR STE 1200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6334
Practice Address - Country:US
Practice Address - Phone:501-664-4131
Practice Address - Fax:501-975-1798
Is Sole Proprietor?:No
Enumeration Date:2012-04-29
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-9829207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology