Provider Demographics
NPI:1780654756
Name:FORBES, JOSEPH DAVIDSON (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DAVIDSON
Last Name:FORBES
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 1:1224 TROTWOOD AVE
Mailing Address - Street 2:BUSINESS OFFICE
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401
Mailing Address - Country:US
Mailing Address - Phone:931-381-1111
Mailing Address - Fax:931-540-4236
Practice Address - Street 1:617 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462
Practice Address - Country:US
Practice Address - Phone:931-796-6201
Practice Address - Fax:931-796-6207
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN024968207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3339316Medicaid
TN3339316Medicare PIN
TNF69819Medicare UPIN