Organization
ROSLYN M TABOR MD LLC
Active
Other names
Summa Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN STEWART (OFFICE MANAGER)
(225) 757-8185
Entity
Organization
Contact information
Practice address
8044 SUMMA AVE, BLDG 1 SUITE A, BATON ROUGE, LA 70809-3411
(225) 757-8185
(225) 757-3837
Mailing address
8044 SUMMA AVE, BLDG 1 SUITE A, BATON ROUGE, LA 70809-3411
(225) 757-8185
(225) 757-3837
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
017770
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1693294
—
LA
Enumeration date
04/23/2008
Last updated
04/23/2008
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