Individual
PIERRE R TIBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
811 AINSWORTH DR, SUITE 109, PRESCOTT, AZ 86301-1687
(928) 771-5595
(928) 771-5596
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(928) 759-5987
(928) 458-2039
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
18934
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291360
—
AZ
01
—
Z232988
MEDICARE
AZ
Enumeration date
07/02/2006
Last updated
11/05/2019
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