Provider Demographics
NPI:1457458895
Name:TALBOT, ROGER LEE SR (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:LEE
Last Name:TALBOT
Suffix:SR
Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:2800 GODWIN BLVD
Mailing Address - Street 2:STE 210
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8038
Mailing Address - Country:US
Mailing Address - Phone:757-934-4162
Mailing Address - Fax:757-934-4246
Practice Address - Street 1:3920 A BRIDGE RD
Practice Address - Street 2:SENTARA OCCUPATIONAL MEDICINE BELLEHARBOUR
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23435
Practice Address - Country:US
Practice Address - Phone:757-983-0080
Practice Address - Fax:757-983-0019
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2016-04-08
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Provider Licenses
StateLicense IDTaxonomies
VA1029961 NCCPA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical