# DR. JACOB TARABOLOUS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1255329819
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 05-32930 | KS | Yes |
| 207L00000X | Anesthesiology Physician | 0532950 | KS | — |
| 207L00000X | Anesthesiology Physician | 2002018397 | MO | — |

## Other

- **Enumeration date:** 10/07/2005
- **Last updated:** 01/30/2014