Individual
THOMAS M. JARBOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1225 S. BROADWAY, SUITE 201, LEXINGTON, KY 40504
(859) 258-4568
(859) 258-4698
Mailing address
1225 S. BROADWAY, SUITE 201, LEXINGTON, KY 40504
(859) 258-4568
(859) 258-4698
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
14574
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290009505
RR MEDICARE PIN
KY
01
—
37903705
MEDICAID GROUP LAB#
KY
01
—
4000501
MEDICARE LAB GROUP#
KY
05
—
64145741
—
KY
01
—
CB 5773
RR GROUP#
KY
Enumeration date
07/14/2006
Last updated
10/10/2012
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