Provider Demographics
NPI:1740208859
Name:WARNER, CARLEEN TALBOT (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLEEN
Middle Name:TALBOT
Last Name:WARNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CARLEEN
Other - Middle Name:DONELLE
Other - Last Name:TALBOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746722
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6722
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:312-929-0373
Practice Address - Street 1:790 NEW HOLLAND AVE STE B
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2137
Practice Address - Country:US
Practice Address - Phone:717-435-1984
Practice Address - Fax:717-674-7688
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20084607OtherAH MERCY-WMG RC
MD642254OtherCAREFIRST MD BCBS
PAP006240OtherGATEWAY-WMG
PA20037638OtherAH MERCY-WMG WHEATLYN
PA2128198OtherMAMSI-WMG
PA50084414OtherCAPITAL BC-WMG WRC
PA154948OtherUNISON-WMG
PA101060552Medicaid
PA20037636OtherAH MERCY-WMG EYFM
PA7726905OtherAETNA
PA50083204OtherCAPITAL BC-WMG VGFM
PA100494OtherGEISINGER
PA107616OtherJOHNS HOPKINS
PA1428576OtherHIGHMARK BLUE SHIELD
PA263748OtherUNISON-WMG RC
PA261037OtherUNISON-WMG VGFM
PA50036853OtherCAPITAL BC-WMG EYFM
PA50036851OtherCAPITAL BC-WMG WHEATLYN
PA081494FLTMedicare PIN
PA081494EZ3Medicare PIN
PA261037OtherUNISON-WMG VGFM
PA50083204OtherCAPITAL BC-WMG VGFM