Healthcare Provider Details

I. General information

NPI: 1659769065
Provider Name (Legal Business Name): JOSEPH TUBBS FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 MARTIN LUTHER KING DR
MARKS MS
38646-1832
US

IV. Provider business mailing address

155 WOODLAND RD
BATESVILLE MS
38606-8459
US

V. Phone/Fax

Practice location:
  • Phone: 662-326-3502
  • Fax: 662-326-2555
Mailing address:
  • Phone: 662-801-3930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR877329
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: