Provider Demographics
NPI:1073523338
Name:TALBOT, THOMAS B (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:B
Last Name:TALBOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 OAKINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN PROVING GROUND
Mailing Address - State:MD
Mailing Address - Zip Code:21005-5131
Mailing Address - Country:US
Mailing Address - Phone:410-278-1727
Mailing Address - Fax:
Practice Address - Street 1:2501 OAKINGTON ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN PROVING GROUND
Practice Address - State:MD
Practice Address - Zip Code:21005-5131
Practice Address - Country:US
Practice Address - Phone:410-278-1727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31337208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics