MEDICARE: HEIDI S TIRB 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
1	207Q00000X	Family Medicine Physician	01074214A	IN
2	207Q00000X	Family Medicine Physician	57660	KY

General Provider Information

NPI Number	:	1306042783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI S TIRB MD

Provider Business Mailing Address
First Line	:	801 SAINT MARYS DR STE 505E
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47714-0528
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 FOUNTAIN CT FL 1
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-2792
Country	:	US
Telephone Number	:	859-218-2626
Fax Number	:	859-257-3322

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	05/30/2023

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Directions to “ HEIDI S TIRB MD” Practice Location

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