Provider Demographics
NPI:1821035791
Name:MINDEN ORTHOPAEDICS, APMC
Entity Type:Organization
Organization Name:MINDEN ORTHOPAEDICS, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:TALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-377-4340
Mailing Address - Street 1:216 W UNION ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3216
Mailing Address - Country:US
Mailing Address - Phone:318-377-4340
Mailing Address - Fax:318-377-4348
Practice Address - Street 1:216 W UNION ST
Practice Address - Street 2:SUITE A
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3216
Practice Address - Country:US
Practice Address - Phone:318-377-4340
Practice Address - Fax:318-377-4348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5062860001OtherDME SUPPLIER
5062860001OtherDME SUPPLIER