Organization
TABOR FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY A TABOR D.O. (OWNER)
(931) 526-4600
Entity
Organization
Contact information
Practice address
406 N WHITNEY AVE STE 3, COOKEVILLE, TN 38501-2455
(931) 537-6367
Mailing address
406 N WHITNEY AVE STE 3, COOKEVILLE, TN 38501-4243
(931) 537-6367
(931) 526-4512
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO1379
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417155292
—
TN
Enumeration date
07/03/2007
Last updated
04/23/2008
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