Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1033146097 Deactivated / Inactive NPI Male Practitioner

Dr. Medardo Tabotabo , MD

Ophthalmology • Middlesboro, KY

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Medardo Tabotabo has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 27, 2006
NPI Deactivation Date February 21, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Medardo Tabotabo, MD was a registered Ophthalmology practicing in Middlesboro, KY. Throughout an active medical career spanning 18 years, Dr. Tabotabo provided care at the practice location at US 25E HWY 441 until profile deactivation on 2024-02-21.

Practice Location & Contact Primary Location

Practice Address

Us 25e Hwy 441

Middlesboro, KY 40965

Telephone 6062423937
Fax 6062481518
Associated Practice Facility / Clinic
🏢 Imaging Consultants, Psc Facility NPI 1225064827

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Middlesboro, KY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 28.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Middlesboro, KY (265 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License KY 24202

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. Ouen Pongdee , MD PSC INC

Radiology - Diagnostic Radiology

NPI 1154367043

MDPSCINC

Dr. Carole Kiphart-Bay , MD

Radiology - Diagnostic Radiology

NPI 1205862794

Doctor of Medicine (M.D.)

Dr. Sunan Vongkasemsiri , MD

Radiology - Diagnostic Radiology

NPI 1275578387

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated February 21, 2024

Record deactivated on February 21, 2024

NPI Profile Active June 08, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location June 08, 2010

Registered at US 25E HWY 441, MIDDLESBORO, KY 40965 (Tel: 6062423937)

📍
Updated Business Mailing Address June 08, 2010

Registered at PO BOX 360, GRAYS KNOB, KY 408290360 (Tel: 6062481320)

👤
Provider Name / Credentials Updated June 08, 2010

Recorded as MEDARDO TABOTABO, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 08, 2010

Ophthalmology (License #24202 in KY)

🟢
Initial NPI Registration & Enumeration June 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Medardo Tabotabo. Be the first to share your experience!

Sign in to leave a review for Dr. Medardo Tabotabo

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1033146097
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 27, 2006
Last Update: June 08, 2010
Deactivation Date: February 21, 2024

Mailing Address

Po Box 360

Grays Knob, KY 408290360

Phone: 6062481320

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.