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General NPI Number Information
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NPI Number | 1437187507
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Entity Type | Organization
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Legal Business Name | TABLER CLINICAL SERVICES, PSC
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 173 SEARS AVE SUITE 274
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City | LOUISVILLE
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State | KY
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Zip | 40207-5059
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Country | US
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Telephone | 502-721-7575
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Fax | 502-721-9682
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Provider Business Mailing Address
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Address Line | 173 SEARS AVE SUITE 274
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City | LOUISVILLE
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State | KY
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Zip | 40207-5059
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Country | US
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Telephone | 502-721-7575
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Fax | 502-721-9682
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES BOSWELL TABLER
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Credential | M.D.
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Telephone | 502-721-7575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 24856
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 24856
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License Number State | KY
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