Provider Demographics
NPI:1750375333
Name:RYBOLT, ANN H (MD)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:H
Last Name:RYBOLT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:605 GLENWOOD DRIVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404
Mailing Address - Country:US
Mailing Address - Phone:423-629-7220
Mailing Address - Fax:423-629-4091
Practice Address - Street 1:605 GLENWOOD DRIVE
Practice Address - Street 2:SUITE 404
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404
Practice Address - Country:US
Practice Address - Phone:423-629-7220
Practice Address - Fax:423-629-4091
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN13688207R00000X
TNMD13688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000719221BMedicaid
TN3004490Medicaid
TN3004490Medicare PIN