Provider Demographics
NPI:1609864727
Name:CLABORN, JOBEY D (DO)
Entity Type:Individual
Prefix:
First Name:JOBEY
Middle Name:D
Last Name:CLABORN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MULESHOE
Mailing Address - State:TX
Mailing Address - Zip Code:79347-3627
Mailing Address - Country:US
Mailing Address - Phone:806-272-6825
Mailing Address - Fax:
Practice Address - Street 1:708 S 1ST ST
Practice Address - Street 2:
Practice Address - City:MULESHOE
Practice Address - State:TX
Practice Address - Zip Code:79347-3627
Practice Address - Country:US
Practice Address - Phone:806-272-6825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8223207N00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131169804Medicaid
TX131169804Medicaid
TXE77532Medicare UPIN