Individual
DR. JOHN JOSEPH TABOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 612, BATON ROUGE, LA 70808-4300
(225) 769-5656
(225) 766-6996
Mailing address
7777 HENNESSY BLVD, SUITE 612, BATON ROUGE, LA 70808-4300
(225) 769-5656
(225) 766-6996
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD.204110
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03128297
—
MS
05
—
1103357
—
LA
Enumeration date
06/12/2008
Last updated
06/12/2015
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