Doctor Name: | MR. PHILLIP R. TALBERT |
NPI Number: | 1053513721 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 102503 |
Business Practice Address: | 935 Wyke Rd Shelby, NC - 281503552 |
Business Phone Number: | 7044811142 |
Business Fax Number: | 7044818305 |
Mailing Address: | 935 Wyke Rd, SHELBY |
State: | NC |
Postal Code: | 281503552 |
Phone Number: | 7044811142 |
Fax Number: | 7044818305 |
NPI Enumeration Date: | 06/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 102503 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |