Provider Demographics
NPI:1386045912
Name:MICHAEL NOBLES, MD, PC
Entity Type:Organization
Organization Name:MICHAEL NOBLES, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOBLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-962-0450
Mailing Address - Street 1:161 SHIRLEY DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2256
Mailing Address - Country:US
Mailing Address - Phone:931-962-0450
Mailing Address - Fax:
Practice Address - Street 1:161 SHIRLEY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2256
Practice Address - Country:US
Practice Address - Phone:931-962-0450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ008651Medicaid