Provider Demographics
NPI:1497957914
Name:TALBERT, MALISSA GOBBELL (MD)
Entity Type:Individual
Prefix:DR
First Name:MALISSA
Middle Name:GOBBELL
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 1:1100 E 3RD ST
Mailing Address - Street 2:UTFP
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2241
Mailing Address - Country:US
Mailing Address - Phone:423-778-8837
Mailing Address - Fax:
Practice Address - Street 1:1100 E 3RD ST
Practice Address - Street 2:UTFP
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2241
Practice Address - Country:US
Practice Address - Phone:423-778-8837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20014207RG0300X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology