Provider Demographics
NPI:1184656563
Name:TUBB, CREIGHTON COLLINS (MD)
Entity Type:Individual
Prefix:DR
First Name:CREIGHTON
Middle Name:COLLINS
Last Name:TUBB
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 1:54 GRUENE PARK DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2460
Mailing Address - Country:US
Mailing Address - Phone:830-625-3481
Mailing Address - Fax:830-609-1997
Practice Address - Street 1:54 GRUENE PARK DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2460
Practice Address - Country:US
Practice Address - Phone:830-625-3481
Practice Address - Fax:830-609-1997
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052109A207X00000X
TXM8394207X00000X
OH35.093113207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2978121Medicaid
IN192770A2Medicare PIN
OH2978121Medicaid