Individual
RICHARD SHANE TUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD,PA-C
Contact information
Practice address
1415 TULANE AVE FL 5, NEW ORLEANS, LA 70112
(504) 988-5561
(504) 988-1731
Mailing address
131 S ROBERTSON ST STE 1300, NEW ORLEANS, LA 70112-2807
(504) 988-5565
(504) 988-5793
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA053
AL
363AS0400X
Surgical Physician Assistant
Primary
PA60600928
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051509068
BCBS OF AL
AL
05
—
051509068
—
AL
01
—
970027041
RR MEDICARE
AL
Enumeration date
08/17/2006
Last updated
10/24/2019
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