Individual
DR. IBRAHIM HEIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
200 S WILCOX DR, BLDG 215, KINGSPORT, TN 37662
(423) 229-5448
(423) 229-1684
Mailing address
200 S WILCOX DR, BLDG 215, PO BOX 1975 MEDICAL DEPT, KINGSPORT, TN 37662
(423) 229-5448
(423) 229-1684
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
27823
SC
2083X0100X
Occupational Medicine Physician
Primary
36260
TN
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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