Tibbels, Jason Kelley
Tibbels, Jason Kelley is an individual health care provider with primary practice located at 2250 S Fm 51 Ste 400 , Decatur TX 76234-3767. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Tibbels, Jason Kelley can be contacted via phone (640) 627-1011.Contact Information
Primary practice address
2250 S Fm 51 Ste 400
Decatur TX 76234-3767
Phone: (640) 627-1011
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | L5154 | Texas |
Profile Details
| NPI number | 1215904222 |
|---|---|
| LBN Legal business name | Tibbels, Jason Kelley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 8th, 2006 |
| Last updated | Aug 17th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215904222 | NPPES |
| Texas | MEDICAID | 156092202 |
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