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NPI Code Detail

MEDICARE: TINA WEBB

MEDICARE:   TINA  WEBB
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
1171W00000XContractor

General Provider Information

NPI Number : 1972120236
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA WEBB
Provider Business Mailing Address
First Line : 9756 YELLOW PINE RD
Second Line :
City : MIDLAND
State : GA
Zip : 31820-4153
Country : US
Telephone Number : 706-763-7969
Fax Number :
Provider Business Practice Location Address
First Line : 9756 YELLOW PINE RD
Second Line :
City : MIDLAND
State : GA
Zip : 31820-4153
Country : US
Telephone Number : 706-763-7969
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2020
Last Update Date : 07/02/2020

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Directions to “ TINA WEBB ” Practice Location

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