Provider Demographics
NPI:1477278794
Name:TUBBS, WILLIAM EARL JR
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:EARL
Last Name:TUBBS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 WINGATE DR
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-2499
Mailing Address - Country:US
Mailing Address - Phone:769-798-0870
Mailing Address - Fax:
Practice Address - Street 1:1207 WINGATE DR
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-2499
Practice Address - Country:US
Practice Address - Phone:769-798-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle