Provider Demographics
NPI:1629214853
Name:TALBERT, JOHN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:TALBERT
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:342 MULE ACADEMY RD
Mailing Address - Street 2:AUGUSTA REGIONAL FREE CLINIC
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2256
Mailing Address - Country:US
Mailing Address - Phone:540-332-5606
Mailing Address - Fax:540-332-5610
Practice Address - Street 1:342 MULE ACADEMY RD
Practice Address - Street 2:AUGUSTA REGIONAL FREE CLINIC
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2256
Practice Address - Country:US
Practice Address - Phone:540-332-5606
Practice Address - Fax:540-332-5610
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA13374174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist