Individual
OWEN B. TABOR SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1244 PRIMACY PKWY, MEMPHIS, TN 38119-0201
(901) 767-8662
(901) 259-2785
Mailing address
PO BOX 8888, BELFAST, ME 04915-8888
(901) 259-4260
(901) 259-2785
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
6996
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000207490 08
UNITED HEALTHCARE
TN
05
—
07187860
—
MS
05
—
120469
—
MS
05
—
3179854
—
TN
05
—
3371161
—
TN
01
—
4039349
AETNA
TN
01
—
4179726
BCBS
TN
01
—
4442032
CIGNA
TN
01
—
620819926
CIGNA
TN
01
—
P00624370
RAILROAD MEDICARE
TN
Enumeration date
02/22/2006
Last updated
03/27/2015
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