Individual
HAGOP M TABAKIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP ANESTHESIA, JACKSONVILLE, FL 32209-6511
(904) 383-1020
(904) 244-1740
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-1740
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
105147
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
105147
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME106558
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0024331-00
—
FL
05
—
531041563A
—
GA
Enumeration date
08/11/2006
Last updated
08/08/2012
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