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General NPI Number Information
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NPI Number | 1609869684
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Entity Type | Individual
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Provider Name | KIMBERLY A TABOR D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1559 SPARTA ST
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City | MCMINNVILLE
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State | TN
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Zip | 37110-1316
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Country | US
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Telephone | 931-815-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 WOODSTEAD CT STE 208
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1480
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Country | US
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Telephone | 877-749-7428
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Fax | 512-628-3314
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 1379
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO1379
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License Number State | TN
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