Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Leo Berman Gibson Jr., RETIRED

Individual provider Family Medicine Physician · NPI 1780688614

Dr. Leo Berman Gibson Jr., RETIRED is a Family Medicine Physician in South Charleston, West Virginia. Licensed in West Virginia. Registered with an NPI since 2005.

Licensed in
WV
In the registry since
2005

Practice location Address checks out

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone: (304) 414-4800
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 1256 (WV)

Record details

NPI number1780688614
Entity typeIndividual (Type 1)
GenderMale
Credentials RETIRED
Sole proprietorNo
NPI enumeratedJune 9, 2005
Last updated in NPPESMay 2, 2022
Certification dateMay 2, 2022

Other providers in South Charleston