Individual
DR. PATRICIA A. TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1203 AVENUE B, ELLISVILLE, MS 39437
(601) 477-3550
(601) 477-9158
Mailing address
PO BOX 6525, LAUREL, MS 39441-6525
(601) 477-3550
(601) 477-9158
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MS15492
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118835
—
MS
Enumeration date
06/27/2005
Last updated
06/20/2011
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