Temple, Tabitha G

Temple, Tabitha G is an sole proprietor health care provider with primary practice located at 2250 N Pointe Dr , Warsaw IN 46582-9042. She recently has only one registered license in Eye and Vision Services Providers / Pediatrics, which is considered as her primary health care specialty. Temple, Tabitha G can be contacted via phone (574) 267-3515.

Contact Information

Primary practice address
2250 N Pointe Dr Warsaw IN 46582-9042
Fax: (574) 267-3259
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Pediatrics 152WP0200X 18002882 Indiana

Profile Details

NPI number 1710971924
LBN Legal business name Temple, Tabitha G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 1st, 2005
Last updated Apr 20th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710971924 NPPES
Indiana MEDICAID 200388760A

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