Provider Demographics
NPI:1720055767
Name:TALBOTT, WILLIAM GARLAND JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GARLAND
Last Name:TALBOTT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 RIVERBEND DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8695
Mailing Address - Country:US
Mailing Address - Phone:434-984-4200
Mailing Address - Fax:434-984-6242
Practice Address - Street 1:125 RIVERBEND DR
Practice Address - Street 2:SUITE 3
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8695
Practice Address - Country:US
Practice Address - Phone:434-984-4200
Practice Address - Fax:434-984-6242
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034548174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE37948Medicare UPIN