National Provider Identifier
Carol Ann Jackson-Gibson, MD
Carol Ann Jackson-Gibson, MD is listed in the NPPES registry with a primary specialty of Diagnostic Radiology Physician in Williamsville, NY and a listed phone number of (716) 688-7622.
Profile Overview
- NPI
- 1164421442
- Provider Type
- Individual
- Primary Specialty
- Diagnostic Radiology Physician
- Enumeration Date
- July 19, 2005
- Last Updated
- March 11, 2013
Practice Location
- 1150 Youngs RD
- Suite 111
- Williamsville, NY 14221-8053
Phone: (716) 688-7622
Specialties
- Diagnostic Radiology Physician (2085R0202X)
- Nuclear Radiology Physician (2085N0904X)
Full Record
- NPI
- 1164421442
- Entity Type
- Individual
- Last Name
- Jackson-Gibson
- First Name
- Carol
- Middle Name
- Ann
- Credential
- MD
- Mailing Street Address
- 1150 Youngs RD
- Mailing Address Line 2
- Suite 111
- Mailing City
- Williamsville
- Mailing State
- NY
- Mailing ZIP Code
- 14221-8053
- Mailing Country
- US
- Mailing Phone
- (716) 688-7622
- Mailing Fax
- (716) 688-7592
- Practice Street Address
- 1150 Youngs RD
- Practice Address Line 2
- Suite 111
- Practice City
- Williamsville
- Practice State
- NY
- Practice ZIP Code
- 14221-8053
- Practice Country
- US
- Practice Phone
- (716) 688-7622
- Practice Fax
- (716) 688-7592
- Enumeration Date
- July 19, 2005
- Last Updated
- March 11, 2013
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Diagnostic Radiology Physician (2085R0202X), Nuclear Radiology Physician (2085N0904X)
- Other Identifiers
- 5609475 (NY, Independent Health #), 01598136 (NY), 000525515015 (NY, Blue Cross Wny #), 150589FF (NY, Preferred Care-Rochester), 300118785 (NY, Railroad Medicare #), CR-DRA176786-2W (NY, Workers Compensation #), 00025193901 (NY, Univera/Excellus #)