Organization
TABLER CLINICAL SERVICES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES BOSWELL TABLER M.D. (PRESIDENT)
(502) 721-7575
Entity
Organization
Contact information
Practice address
173 SEARS AVE, SUITE 274, LOUISVILLE, KY 40207-5059
(502) 721-7575
(502) 721-9682
Mailing address
173 SEARS AVE, SUITE 274, LOUISVILLE, KY 40207-5059
(502) 721-7575
(502) 721-9682
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24856
KY
2084P0805X
Geriatric Psychiatry Physician
24856
KY
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000069035
ANTHEM
KY
05
—
100027380
—
IN
01
—
107287
SIHO
IN
05
—
7100101770
—
KY
05
—
78902996
—
KY
Enumeration date
06/29/2006
Last updated
06/05/2014
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