Provider Demographics
NPI:1114009362
Name:TRIBBLE, CURTIS G (MD)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:G
Last Name:TRIBBLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0001
Practice Address - Country:US
Practice Address - Phone:434-243-1000
Practice Address - Fax:434-243-7551
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010338642086S0102X, 208G00000X
MS20791208G00000X
FLME97567208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP01234013OtherRAILROAD MEDICARE
FL277323600Medicaid
MS04578259Medicaid
MSP01234013OtherRAILROAD MEDICARE
MS302I330819Medicare PIN
MS$$$$$$$$$OtherBLUE CROSS BLUE SHIELD
MS04578259Medicaid
MS302I335646Medicare PIN