Healthcare Provider Details

I. General information

NPI: 1003319880
Provider Name (Legal Business Name): ISAAC CLAYTON TALBERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2018
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N KANSAS ST
WICHITA KS
67214-3124
US

IV. Provider business mailing address

1090 ARNOLD DR
JACKSONVILLE AR
72099-4933
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-5000
  • Fax:
Mailing address:
  • Phone: 501-987-7319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberE-12497
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number94-11640
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: