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General NPI Number Information
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NPI Number | 1457363590
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH TARBOX D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 1755 US ROUTE 6 W
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City | ROULETTE
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State | PA
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Zip | 16746-1025
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Country | US
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Telephone | 814-544-3182
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Fax | 814-544-3184
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Provider Business Mailing Address
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Address Line | 1755 US ROUTE 6 W
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City | ROULETTE
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State | PA
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Zip | 16746-1025
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Country | US
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Telephone | 814-544-3182
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Fax | 814-544-3184
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC005851
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License Number State | PA
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