Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 5352 | AL |
Y | 213EG0000X | General Practice | 5352 | AL |
NPI | 1003809591 |
---|---|
Provider Name | Dr. Joann Tubbs Crim |
First Address | Owens Cross Roads, AL 35763-9787 |
Second Address | Owens Cross Roads, AL 35763-9787 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 08/04/2008 |