MEDARDO TABOTABO (NPI# 1033146097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033146097 |
| Entity Type | Individual |
| Full Name | MEDARDO TABOTABO |
| Credential | M.D. |
| Practice Address |
Us 25e Hwy 441 Middlesboro KY 40965 |
| Mailing Address |
Po Box 360 Grays Knob KY 40829-0360 |
| Practice Telephone | 6062423937 |
| Practice Fax Number | 6062481518 |
| Mailing Telephone | 6062481320 |
| Mailing Fax Number | 6062481518 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2010-06-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 24202 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64242027 | 05 |
| Street Address |
US 25E HWY 441 |
| City | MIDDLESBORO |
| State | KY |
| Zip Code | 40965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387064 | Christopher Bruce Ellison | Social Worker | 809 19th Street, Middlesboro, KY 40965 | 2019-10-14 |
| 1982255030 | Johnny Wade Nantz II | Case Manager/Care Coordinator | 809 N 19th St, Middlesboro, KY 40965 | 2019-09-20 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1558843227 | Bethany Lauren Wade | Case Manager/Care Coordinator | 19th St, 809, Middlesboro, KY 40965 | 2018-08-30 |
| 1124521505 | Sonya Joyce Mcneil | Speech-Language Pathologist | Kidabilities Pediatric Therapy Center, 2801 Highway 25e, Suite 98, Middlesboro, KY 40965 | 2018-03-13 |
| 1518499862 | Vikki Lynn Johnson | Case Manager/Care Coordinator | 809 North 19th Street, Middlesboro, KY 40965 | 2017-03-28 |
| 1184164287 | Wilson Jeffrey | Occupational Therapist | Address: 235 New Wilson Lane, Middlesboro, KY 40965 | 2017-03-08 |
| 1447797444 | Lesha Loretta Williams | Physician Assistant | 2004 Cumberland Ave Ste 100, Middlesboro, KY 40965 | 2017-01-27 |
| 1619423910 | Audra Anissa Hall | Physical Therapist | 108 Turner Lane, Middlesboro, KY 40965 | 2016-08-28 |
| 1700332061 | Tammy Mclain | Counselor | Selfrefind 809 North 19th Street, Middlesboro, KY 40965 | 2016-08-28 |
| Find all providers in zip 40965 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405779 | David Sanford | Ophthalmology | 1502 Cumberland Ave, Middlesboro, KY 40965-1223 | 2005-05-24 |
| 1013015510 | Kentucky Institute for Eye Health & Surgery | Ophthalmology | 1431 E Cumberland Ave, Middlesboro, KY 40965-1117 | 2006-09-20 |
| 1285740951 | David G. Sanford, M.d., P.s.c. | Ophthalmology | 1502 Cumberland Ave, Middlesboro, KY 40965-1223 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831722958 | Kentucky Eye Institue for Eye Health & Surgery | Ophthalmology | 130 Thompson Poynter Rd Ste 1, London, KY 40741-7280 | 2020-02-17 |
| 1558710970 | Christopher Areephanthu | Ophthalmology | 825 2nd Ave Ste A5, Bowling Green, KY 42101-1789 | 2016-06-07 |
| 1336503820 | Manan Raju Sampat | Ophthalmology | 1541 Lebanon Rd Ste 2, Danville, KY 40422-8349 | 2016-04-11 |
| 1588026181 | Michael S Tanner | Ophthalmology | 2720 Old Rosebud Rd Ste 110, Lexington, KY 40509-8005 | 2016-03-23 |
| 1528458023 | Senior Health Services LLC | Ophthalmology | 2410 Ring Rd, Suite 400, Elizabethtown, KY 42701-7994 | 2015-02-04 |
| 1447649827 | Senior Health Services LLC | Ophthalmology | 800 W Lincoln Trail Blvd, Suite 108, Radcliff, KY 40160-2671 | 2015-01-22 |
| 1477950269 | Tri-state Centers for Sight, Inc | Ophthalmology | 802 Scott St, Covington, KY 41011-2420 | 2014-11-24 |
| 1437554102 | Kyle M Ferguson | Ophthalmology | 1937 Old Main St Ste 1, Maysville, KY 41056-8956 | 2014-10-23 |
| 1609282375 | James Matthew Huffman | Ophthalmology | 120 N Eagle Creek Dr Ste 431, Lexington, KY 40509 | 2014-07-02 |
| 1588086508 | Lori Bettenhausen Williams | Ophthalmology | 1413 Evergreen Rd, Anchorage, KY 40223 | 2014-01-09 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLESBORO |
| Zip Code | 40965 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.