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1497318646

NPI Code Detail

MEDICARE: GABY K. JABBOUR MD

MEDICARE: GABY K. JABBOUR MD

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	207Q00000X	Family Medicine Physician	MD70096387	WA
2	2086S0102X	Surgical Critical Care Physician	E-15727	AR
3	2084A2900X	Neurocritical Care Physician	E-15727	AR
4	208D00000X	General Practice Physician	34330	WV
5	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1497318646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABY K. JABBOUR MD

Provider Business Mailing Address
First Line	:	120 LOCUST AVE EXT
Second Line	:
City	:	MOUNT MORRIS
State	:	PA
Zip	:	15349-1355
Country	:	US
Telephone Number	:	724-324-9001
Fax Number	:	724-324-9005

Provider Business Practice Location Address
First Line	:	940 NORTHGATE DR
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-3505
Country	:	US
Telephone Number	:	509-942-2516
Fax Number	:	509-942-2527

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

Provider Enumeration Date	:	04/15/2019
Last Update Date	:	06/04/2026

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Directions to “ GABY K. JABBOUR MD” Practice Location

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