MEDICARE: R. P. SABO, M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	40009	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205824984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R. P. SABO, M.D., P.C.

Provider Business Mailing Address
First Line	:	1524 SPARTA ST
Second Line	:
City	:	MC MINNVILLE
State	:	TN
Zip	:	37110-1317
Country	:	US
Telephone Number	:	931-474-4136
Fax Number	:	931-474-4137

Provider Business Practice Location Address
First Line	:	1524 SPARTA ST
Second Line	:
City	:	MC MINNVILLE
State	:	TN
Zip	:	37110-1317
Country	:	US
Telephone Number	:	931-474-4136
Fax Number	:	931-474-4137

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT PATTISON SABO
Credential	:	M.D.
Telephone Number	:	931-474-4136

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	08/22/2020

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