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General NPI Number Information
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NPI Number | 1528223369
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Entity Type | Individual
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Provider Name | JOHN MICHAEL TABIT D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 120 PROFESSIONAL PARK
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City | BECKLEY
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State | WV
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Zip | 25801-3623
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Country | US
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Telephone | 304-410-0061
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Fax | 304-410-0574
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Provider Business Mailing Address
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Address Line | 120 PROFESSIONAL PARK
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City | BECKLEY
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State | WV
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Zip | 25801-3623
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Country | US
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Telephone | 304-410-0061
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Fax | 304-410-0574
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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 | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | 2621
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 34.009284
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License Number State | OH
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