Mark James Tabor, DO/PHD

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

Practice address

418 Coolidge Avenue #42
Holden, WV 25625-0082

Phone

(304) 792-0541

NPI assigned

Sep 24, 2020

Last updated

Sep 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy, Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1346857257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82",
            "city": "HOLDEN",
            "state": "WV",
            "postal_code": "256250082",
            "telephone_number": "304-792-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 COOLIDGE AVENUE #42",
            "city": "HOLDEN",
            "state": "WV",
            "postal_code": "256250082",
            "telephone_number": "304-792-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABOR",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO/PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ph.D. Medical Genetics in Holden, WV
• Providers in Holden, WV by specialty
• Ph.D. Medical Genetics in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.