Provider Demographics
NPI:1407918741
Name:TALBERT, JEAN E (MD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:E
Last Name:TALBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 PALMER AVE
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540
Mailing Address - Country:US
Mailing Address - Phone:508-457-0088
Mailing Address - Fax:508-540-9613
Practice Address - Street 1:182 PALMER AVE
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:508-457-0088
Practice Address - Fax:508-540-9613
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73950207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3078965Medicaid
MAJ10851Medicare ID - Type Unspecified
MAE77294Medicare UPIN