Individual
PHILLIP A TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 ROSE ST, MS 106, LEXINGTON, KY 40536-7001
(859) 323-5661
(859) 257-8902
Mailing address
800 ROSE ST, MS 106, LEXINGTON, KY 40536-7001
(859) 323-5661
(859) 257-8902
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
17671
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64176712
—
KY
Enumeration date
05/02/2006
Last updated
05/02/2022
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