Provider Demographics
NPI:1023065232
Name:DIBBLE, TIMOTHY D (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:D
Last Name:DIBBLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-297-2700
Practice Address - Fax:615-386-2399
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2015-06-03
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Provider Licenses
StateLicense IDTaxonomies
TN38757207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN12268283OtherMULTIPLAN/PHCS
TN1100618400OtherUSA PPO/GEHA
TN010077840OtherAMERIGROUP - TNCARE ONLY
KY64094659Medicaid
TN515532OtherUSA MANAGED CARE
TN3895256Medicaid
TN139484OtherCOVENTRY
TN2099225OtherUNITED HEALTH CARE
TN9140448OtherCIGNA POS, PPO
TN4087632OtherBLUE CROSS OF TN
TNP00133883OtherMEDICARE RR
TNTN0116OtherAMERICHOICE TNCARE ONLY
TN515532OtherUSA MANAGED CARE
KY64094659Medicaid