Provider Demographics
NPI:1952643140
Name:TALBOT, GEORGE HARRISON (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:HARRISON
Last Name:TALBOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W LANCASTER AVE
Mailing Address - Street 2:# 141
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3938
Mailing Address - Country:US
Mailing Address - Phone:610-710-1600
Mailing Address - Fax:
Practice Address - Street 1:133 N WAYNE AVE
Practice Address - Street 2:#2
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3561
Practice Address - Country:US
Practice Address - Phone:610-710-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018740E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist