# TERESA J TIBBETTS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1750486445
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 27163 | AZ | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 02/09/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2Z2286 | HEALTH NET PROVIDER \# | AZ |
| 05 | — | 474429 | — | AZ |
| 01 | — | AZ0769200 | BLUE CROSS BLUE SHIELD \# | AZ |
| 01 | — | DD0854 | RAILROAD MEDICARE GROUP \# | AZ |
| 01 | — | Z102474 | MEDICARE INDIVIDUAL PTAN | AZ |
| 01 | — | Z102475 | MEDICARE GROUP PTAN | AZ |