MEDICARE: DR. TABATHA JEAN BARBER D.O.

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	207VG0400X	Gynecology Physician	5101016413	MI

General Provider Information

NPI Number	:	1336369701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TABATHA JEAN BARBER D.O.

Provider Business Mailing Address
First Line	:	18008 WOODLAND TRL
Second Line	:
City	:	SPRING LAKE
State	:	MI
Zip	:	49456-2826
Country	:	US
Telephone Number	:	616-502-1484
Fax Number	:	866-651-5153

Provider Business Practice Location Address
First Line	:	18008 WOODLAND TRL
Second Line	:
City	:	SPRING LAKE
State	:	MI
Zip	:	49456-2826
Country	:	US
Telephone Number	:	616-502-1484
Fax Number	:	866-651-5153

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	11/17/2023

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