Provider Demographics
NPI:1356318828
Name:TALTON, ROBERT KEVIN (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:KEVIN
Last Name:TALTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:910-662-6200
Mailing Address - Fax:910-686-1606
Practice Address - Street 1:7420 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-9453
Practice Address - Country:US
Practice Address - Phone:910-662-6200
Practice Address - Fax:910-686-1606
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0098-01525207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89126WWMedicaid
NC89126WWMedicaid
NC2280245AMedicare PIN