Doctor Name: | JOSHUA TALBERT |
NPI Number: | 1073525671 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A. |
License Number: | PA02779 |
Business Practice Address: | 4909 North St Ste 202 Nacogdoches, TX - 759651808 |
Business Phone Number: | 9365609898 |
Business Fax Number: | |
Mailing Address: | 4909 North St Ste 202, NACOGDOCHES |
State: | TX |
Postal Code: | 759651808 |
Phone Number: | 9365609898 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2006 |
NPI Last Update Date: | 05/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA02779 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |