Individual
RODOLPHE TABY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5683
(928) 855-8185
Mailing address
12603 N FALLEN SHADOWS DR, MARANA, AZ 85658-4497
(832) 885-3499
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
59752
AZ
207Q00000X
Family Medicine Physician
80985
GA
207Q00000X
Family Medicine Physician
9527A
WY
208M00000X
Hospitalist Physician
80985
GA
208M00000X
Hospitalist Physician
9527A
WY
Other
Enumeration date
06/08/2011
Last updated
02/26/2021
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