Provider Demographics
NPI:1285671198
Name:COOMBS, JANET HAAS (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:HAAS
Last Name:COOMBS
Suffix:
Gender:F
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 246
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:TN
Mailing Address - Zip Code:37353-0246
Mailing Address - Country:US
Mailing Address - Phone:423-716-0963
Mailing Address - Fax:423-614-3372
Practice Address - Street 1:5057 S LEE HWY
Practice Address - Street 2:
Practice Address - City:MC DONALD
Practice Address - State:TN
Practice Address - Zip Code:37353-5778
Practice Address - Country:US
Practice Address - Phone:423-614-3372
Practice Address - Fax:423-614-3372
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD29572208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3066326OtherBCBST
TN3814488Medicaid
TN3066326OtherBCBST
TN3814488Medicaid