Individual
ROBERT R TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
530 SOUTH JACKSON STREET, DHC, LOUISVILLE, KY 40202
(502) 562-6500
(502) 562-6196
Mailing address
501 E BROADWAY, #220, LOUISVILLE, KY 40202-1785
(502) 589-4856
(502) 589-5093
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA500
KY
Other
Enumeration date
05/23/2006
Last updated
07/08/2007
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