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Individual

LISA TUBBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
2014 BALTIMORE REYNOLDSBURG RD, REYNOLDSBURG, OH 43068-3261
(614) 522-6900
Mailing address
5450 FRANTZ RD STE 360, DUBLIN, OH 43016-4141
(419) 520-2495

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0129137
OH
Enumeration date
11/19/2012
Last updated
11/07/2019
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