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NPI Code Detail

MEDICARE: ANN ELIZABETH TEBOW MD

MEDICARE: ANN ELIZABETH TEBOW MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1851989248
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN ELIZABETH TEBOW MD
Provider Business Mailing Address
First Line : 2650 NW 12TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73107-5420
Country : US
Telephone Number : 405-420-3703
Fax Number :
Provider Business Practice Location Address
First Line : 1125 N COLLEGE AVE # SLOT100
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1908
Country : US
Telephone Number : 479-713-8310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2021
Last Update Date : 05/06/2026

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Directions to “ ANN ELIZABETH TEBOW MD” Practice Location

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