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General NPI Number Information
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NPI Number | 1285971895
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Entity Type | Organization
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Legal Business Name | TIMOTHY B TABOR MD PC
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 1701 PELHAM RD S
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City | JACKSONVILLE
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State | AL
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Zip | 36265-3369
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Country | US
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Telephone | 256-782-4529
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Fax | 256-782-4425
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Provider Business Mailing Address
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Address Line | PO BOX 117
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City | CULLMAN
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State | AL
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Zip | 35056-0117
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Country | US
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Telephone | 256-737-9828
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Fax | 256-739-5893
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Authorized Official
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Title or Position | MANAGER
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Name | MR. STEPHEN P BYRUM
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Credential |
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Telephone | 256-737-9828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 1568
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License Number State | AL
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