OrganizationRoslyn M Tabor Md Llc(<Unavail>)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address8044 Summa Ave, Bldg 1 Suite A, Baton Rouge, LA 70809-3411(225) 757-8185PECOS EnrollmentBased on the most recent information from CMS, provider Roslyn M Tabor Md Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1770758542Provider TypeOrganizationFull NameRoslyn M Tabor Md LlcOther Name<Unavail>SubpartNoEnumeration Date4/23/2008Last Updated4/23/2008Contact InformationPractice LocationPractice Address8044 Summa Ave, Bldg 1 Suite A, Baton Rouge, LA 70809-3411Phone(225) 757-8185Fax(225) 757-3837Mailing LocationMailing Address8044 Summa Ave, Bldg 1 Suite A, Baton Rouge, LA 70809-3411Phone(225) 757-8185Fax(225) 757-3837Authorized OfficialNameStewart, Susan (Office Manager)Phone(225) 757-8185Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense017770LouisianaProvider IdentifiersIDDescriptionIssuerID1693294DescriptionMedicaidIssuerUnlistedLouisiana