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Individual

VIBHA JAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1325 WOLF PARK DR STE 102, GERMANTOWN, TN 38138-1759
(901) 252-3400
(901) 763-4305
Mailing address
1325 WOLF PARK DR STE 103, GERMANTOWN, TN 38138-1759
(901) 252-3400
(901) 763-4305

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
40092
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
43624
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01066918A
STATE LICENSURE
IN
05
200949400
IN
01
40092
MEDICAL LICENSURE
KY
Enumeration date
06/12/2007
Last updated
08/27/2024
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