Provider Demographics
NPI:1831294891
Name:BIEBER, JEFFRY DWAYNE (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFFRY
Middle Name:DWAYNE
Last Name:BIEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:303 MED TECH PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2391
Mailing Address - Country:US
Mailing Address - Phone:423-794-3040
Mailing Address - Fax:423-794-3041
Practice Address - Street 1:303 MED TECH PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2391
Practice Address - Country:US
Practice Address - Phone:423-794-3040
Practice Address - Fax:423-794-3041
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000035083207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010127203Medicaid
H37343Medicare UPIN
TN103I665065Medicare PIN