MEDICARE: DR. ANDREW P. TALBOTT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician	6353467-1205	UT

General Provider Information

NPI Number	:	1619932761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW P. TALBOTT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 912042
Second Line	:
City	:	SAINT GEORGE
State	:	UT
Zip	:	84791-2042
Country	:	US
Telephone Number	:	435-656-2424
Fax Number	:	435-656-2828

Provider Business Practice Location Address
First Line	:	1122 CENTER DR STE D350
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84098-5780
Country	:	US
Telephone Number	:	435-714-7277
Fax Number	:	435-214-2254

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	11/04/2025

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