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NPI Code Detail

MEDICARE: PAIGE U TIBBETTS

MEDICARE: PAIGE U TIBBETTS
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
1171M00000XCase Manager/Care CoordinatorOH

General Provider Information

NPI Number : 1811372261
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE U TIBBETTS
Provider Business Mailing Address
First Line : 204 COOK RD
Second Line : SUITE 400
City : LEBANON
State : OH
Zip : 45036-9600
Country : US
Telephone Number : 513-228-7800
Fax Number : 513-695-2952
Provider Business Practice Location Address
First Line : 6300 N MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45415-3154
Country : US
Telephone Number : 937-275-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2015
Last Update Date : 03/27/2018

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Directions to “ PAIGE U TIBBETTS ” Practice Location

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