Doctor Name: | DR. LENITA THIBAULT |
NPI Number: | 1659391092 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 21333 |
Business Practice Address: | 135 W Ravine Rd Suite 1a Kingsport, TN - 376603847 |
Business Phone Number: | 4232244920 |
Business Fax Number: | 4232244929 |
Mailing Address: | 999 Executive Park Blvd, Suite 201 KINGSPORT |
State: | TN |
Postal Code: | 376604632 |
Phone Number: | 4232243250 |
Fax Number: | 4232243258 |
NPI Enumeration Date: | 07/20/2006 |
NPI Last Update Date: | 07/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 21333 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |