Individual
DR. JACOB EDWARD TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
740 REENA AVE, FORT ATKINSON, WI 53538-3145
(920) 563-0888
(920) 568-3516
Mailing address
740 REENA AVE, FORT ATKINSON, WI 53538-3145
(920) 563-0888
(920) 568-3516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
81240-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235711573
—
WI
Enumeration date
04/26/2021
Last updated
08/13/2024
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