Whalio Doctors

NPI 1225020480

Jean Henderson Tibbetts, MD

Practitioner Specialist Bangor, ME

Practice location

Address
417 State St Suite 230, Bangor, ME 04401-6630
Phone
(207) 947-1291
Fax
(207) 947-9241

Registered specialties

Specialist Primary
Other Service Providers Taxonomy 174400000X Licence 011702 (ME)

Registry record

NPI
1225020480
Entity type
Individual
Sex (as registered)
Female
NPI issued
15 Aug 2005
Record last updated
29 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.