Individual
RICHARD A TIBBALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8009
(812) 473-2060
(812) 473-0763
Mailing address
1020 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8009
(812) 473-2060
(812) 473-0763
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01024335A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381551
ANTHEM
IN
01
—
000000381551
ANTHEM
KY
05
—
100246470A
—
IN
01
—
113537
HEALTH ALLIANCE
IN
01
—
128718
HEALTHLINK
IN
01
—
P00280944
RR MEDICARE
IN
Enumeration date
03/17/2006
Last updated
11/14/2011
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