Provider Demographics
NPI:1649230863
Name:KRIBBS, JOHN B (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:KRIBBS
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-637-3373
Mailing Address - Fax:704-637-0069
Practice Address - Street 1:650 JULIAN RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-9078
Practice Address - Country:US
Practice Address - Phone:704-637-3373
Practice Address - Fax:704-637-0069
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400090207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC50352OtherBLUE CROSS BLUE SHIELD NC
NC8950352Medicaid
NC8950352Medicaid
NC2195078DMedicare PIN
B91496Medicare UPIN