Provider Demographics
NPI:1083922959
Name:TALLEY, ARNOLD KEITH JR
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:KEITH
Last Name:TALLEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 NW CARY PKWY
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7235
Mailing Address - Country:US
Mailing Address - Phone:919-678-8257
Mailing Address - Fax:
Practice Address - Street 1:1990 NW CARY PKWY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-7235
Practice Address - Country:US
Practice Address - Phone:919-678-8257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16891183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist