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Individual

ERIC NEAL TABOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2780 GAUSE BLVD E, SUITE A, SLIDELL, LA 70461-4149
(985) 641-5198
(985) 641-5398
Mailing address
2780 GAUSE BLVD E, SUITE A, SLIDELL, LA 70461-4149
(985) 641-5198
(985) 641-5398

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
12278R
LA
207N00000X
Dermatology Physician
15605
MS
207N00000X
Dermatology Physician
G81348
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00119852
MS
05
1695149
LA
Enumeration date
04/11/2006
Last updated
09/11/2013
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