VIRGINIA ANNE KOUBEK (NPI# 1962644013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962644013 |
| Entity Type | Individual |
| Full Name | VIRGINIA ANNE KOUBEK |
| Credential | M.D. |
| Practice Address |
87 Murray Guard Dr Ste B Jackson TN 38305-3775 |
| Mailing Address |
Po Box 400 Jackson TN 38302-0400 |
| Practice Telephone | 7316641375 |
| Practice Fax Number | 7316608319 |
| Mailing Telephone | 7314238697 |
| Mailing Fax Number | 7314255783 |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2014-12-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 51924 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
87 MURRAY GUARD DR STE B |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-3775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740791847 | Brian Blake Childress | Physician Assistant | 87 Murray Guard Dr Ste B, Jackson, TN 38305-3775 | 2017-10-16 |
| 1700266558 | Buckley Parker | Physician Assistant | 87 Murray Guard Dr Ste B, Jackson, TN 38305-3775 | 2015-06-08 |
| 1841581261 | Kimberly W Preston | Nurse Practitioner | 87 Murray Guard Dr Ste B, Jackson, TN 38305-3775 | 2011-04-20 |
| 1437386232 | Emily T Wolfe | Surgery | 87 Murray Guard Dr Ste B, Jackson, TN 38305-3775 | 2009-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427408319 | Advanced Dermatology of Wyoming, Inc | Dermatology | 62 South Redmond Street, Jackson, WY 83001-8664 | 2016-06-21 |
| 1871814095 | Elizabeth Anne Gordon Spratt | Dermatology | 3333 Spring Arbor Rd Ste 500, Jackson, MI 49203-8605 | 2010-06-22 |
| 1053532226 | Julie P Wyatt | Dermatology | 3000 Old Canton Rd Ste 430, Jackson, MS 39216 | 2007-05-02 |
| 1265653745 | Brittany Wilson Baker | Dermatology | 984 W Broadway, Suite 4, Jackson, WY 83001-0000 | 2007-05-01 |
| 1982705570 | Louis Julian Wise Jr. | Dermatology | 3000 Old Canton Road, Suite 430, Jackson, MS 39216 | 2006-09-26 |
| 1215940937 | Sterling Ruffin Craig | Dermatology | 2817 North Highland Avenue, Suite A, Jackson, TN 38305-1789 | 2006-08-14 |
| 1366459026 | Chemene Quinn | Dermatology | 501 Marshall St Ste 406, Dermatology Consultants, Pllc, Jackson, MS 39202-1650 | 2006-08-02 |
| 1609893296 | Kenneth R. Maloney | Dermatology | 294 Summar Drive, Jackson, TN 38301 | 2006-07-17 |
| 1720039423 | William P Teer | Dermatology | 1320 Union University Dr, Jackson, TN 38305-3780 | 2006-05-15 |
| 1447233754 | Jonathan Glenn Baker | Dermatology | 984 West Broadway, Suite 4, Jackson, WY 83001-0000 | 2005-11-22 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.