Provider Demographics
NPI:1194814285
Name:TALEON, ORLANDO ANGELO LIZARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ORLANDO ANGELO
Middle Name:LIZARDO
Last Name:TALEON
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:PO BOX 8003
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54912-8003
Mailing Address - Country:US
Mailing Address - Phone:920-731-5811
Mailing Address - Fax:920-738-5787
Practice Address - Street 1:2500 E CAPITOL DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-8735
Practice Address - Country:US
Practice Address - Phone:920-731-5811
Practice Address - Fax:920-738-6293
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48388-020207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI450030624OtherMEDICARE PTAN
WI711290048OtherMEDICARE PTAN