Provider Demographics
NPI:1043653280
Name:WEBB, SAMUEL B (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:B
Last Name:WEBB
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 1:1106 ELLISTON WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-4408
Mailing Address - Country:US
Mailing Address - Phone:156-791-8581
Mailing Address - Fax:704-446-1241
Practice Address - Street 1:1106 ELLISTON WAY STE 101
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-4408
Practice Address - Country:US
Practice Address - Phone:615-791-8581
Practice Address - Fax:615-791-6167
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN59241207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine