Provider Demographics
NPI:1447396858
Name:HUBBS, DORIS W TAAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:W TAAM
Last Name:HUBBS
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 1:1105 W STONE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-2558
Mailing Address - Country:US
Mailing Address - Phone:423-246-0010
Mailing Address - Fax:
Practice Address - Street 1:1105 W STONE DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-2558
Practice Address - Country:US
Practice Address - Phone:423-246-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 019972207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64662679Medicaid
TN30589541Medicaid
TNP00455118Medicare PIN
TNE81397Medicare UPIN
KY64662679Medicaid
TN30589541Medicare PIN