Individual
MARTHA K TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5959 PARK AVE, RADIOLOGY DEPARTMENT, MEMPHIS, TN 38119-5200
(901) 765-3212
(901) 765-1727
Mailing address
PO BOX 2044 DEPT 2600, MEMPHIS, TN 38101-2044
(901) 765-3212
(901) 765-1727
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD029014
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118726
—
MS
05
—
132048001
—
AR
05
—
203822408
—
MO
05
—
3812389
—
TN
Enumeration date
05/20/2006
Last updated
10/10/2011
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