Provider Demographics
NPI:1902586225
Name:TIBBELS, JOSHUA P (PAC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:P
Last Name:TIBBELS
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Gender:M
Credentials:PAC
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Mailing Address - Street 1:130 NORTH ST STE A
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3825
Mailing Address - Country:US
Mailing Address - Phone:508-775-8282
Mailing Address - Fax:508-775-8280
Practice Address - Street 1:130 NORTH ST STE A
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3825
Practice Address - Country:US
Practice Address - Phone:508-568-3761
Practice Address - Fax:508-775-8280
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-27
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant