Individual
PATRICK M TIBBLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-8222
(605) 719-4203
Mailing address
PO BOX 912882, DENVER, CO 80291-2882
(866) 765-0909
(855) 856-8520
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4331
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1459655
—
ND
05
—
1861582124
—
CO
05
—
1861582124
—
SD
Enumeration date
10/14/2006
Last updated
01/11/2019
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