Provider Demographics
NPI:1508090424
Name:CULVER, TABITHA DAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:TABITHA
Middle Name:DAWN
Last Name:CULVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TABITHA
Other - Middle Name:DAWN
Other - Last Name:HOCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2716 OLD ROSEBUD RD
Mailing Address - Street 2:SUITE 351
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8008
Mailing Address - Country:US
Mailing Address - Phone:859-245-6671
Mailing Address - Fax:859-245-6672
Practice Address - Street 1:2716 OLD ROSEBUD RD
Practice Address - Street 2:SUITE 351
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8008
Practice Address - Country:US
Practice Address - Phone:859-245-6671
Practice Address - Fax:859-245-6672
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY44475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100205850Medicaid