Organization Name: | TALTON PHYSICIAN SERVICES PLLC |
NPI Number: | 1417261736 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT KEVIN TALTON (OWNER) |
Mailing Address: | 201 Crest Dr Mount Olive |
State: | NC US |
Postal Code: | 283652619 |
Phone Number: | 9192225908 |
Fax Number: | |
NPI Enumeration Date: | 07/28/2010 |
NPI Last Update Date: | 07/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | 9801525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |