Provider Demographics
NPI:1295010353
Name:TALBOT, FRANK
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:TALBOT
Suffix:
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 1:4374 NAVIN FIELD LN
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-5732
Mailing Address - Country:US
Mailing Address - Phone:248-219-9451
Mailing Address - Fax:
Practice Address - Street 1:53069 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-2577
Practice Address - Country:US
Practice Address - Phone:586-781-2655
Practice Address - Fax:586-781-6714
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302023733183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist