Individual
JACK VIBBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
70 PLAZA DR, PELL CITY, AL 35125-9314
(205) 814-9284
(205) 814-9626
Mailing address
70 PLAZA DR, PELL CITY, AL 35125-9314
(205) 814-9284
(205) 814-9626
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO.2148
AL
207Q00000X
Family Medicine Physician
L4569R
AL
Other
Enumeration date
11/02/2017
Last updated
06/12/2020
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