Medardo Tabotabo
Ophthalmologist
Us 25e Hwy 441
Middlesboro
, Kentucky 40965
Medardo Tabotabo
Ophthalmologist
Us 25e Hwy 441
Middlesboro
, Kentucky 40965
(606) 248-1518
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About
Features
Specialties
- Ophthalmologist
Languages spoken
- English
Location
First Address
- Medardo Tabotabo
- Po Box 360
- Grays Knob, KY
- Zip : 40829-0360
- Fax : (606) 248-1518
- Phone : (606) 248-1320
Second Address
- Medardo Tabotabo
- Us 25e Hwy 441
- Middlesboro, KY
- Zip : 40965
- Fax : (606) 248-1518
- Phone : (606) 242-3937
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207W00000X | Ophthalmologist | 24202 | KY |
National Provider Identifier
| NPI | 1033146097 |
|---|---|
| Provider Name | Medardo Tabotabo |
| First Address | Grays Knob, KY 40829-0360 |
| Second Address | Middlesboro, KY 40965 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/06/2006 |
| Last Update Date | 08/06/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 64242027 | (05) | KY |
| C65494 | (02) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.