Individual
JESSICA B TUBERTY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1937 W ELK AVE, ELIZABETHTON, TN 37643-3734
(423) 547-9400
(423) 547-9401
Mailing address
1937 W ELK AVE, ELIZABETHTON, TN 37643-3734
(423) 547-9400
(423) 547-9401
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD40221
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3336052
—
TN
01
—
4115429
BCBS
TN
01
—
TN0103
JOHN DEERE
TN
Enumeration date
06/02/2006
Last updated
07/08/2007
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