Provider Demographics
NPI:1619966330
Name:TALBERT, TIMOTHY M (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:M
Last Name:TALBERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:211 SAINT FRANCIS DR
Mailing Address - Street 2:ATTN MEDICAL AFFAIRS
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-5049
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:2341 MCCALLIE AVE
Practice Address - Street 2:PLAZA 3 SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3239
Practice Address - Country:US
Practice Address - Phone:423-629-4106
Practice Address - Fax:423-629-4116
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2021-01-27
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Provider Licenses
StateLicense IDTaxonomies
MO2021001785207RC0001X
TN20015207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3091466Medicare PIN
TNF06518Medicare UPIN
TNP00160362Medicare PIN
GA06BDHQQMedicare PIN