Healthcare Provider Details

I. General information

NPI: 1013240159
Provider Name (Legal Business Name): LADAWN M. TALBOTT, MD, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 RALSTON ST SUITE 200
RENO NV
89503-4456
US

IV. Provider business mailing address

601 RALSTON ST SUITE 200
RENO NV
89503-4456
US

V. Phone/Fax

Practice location:
  • Phone: 775-348-4790
  • Fax: 775-348-5928
Mailing address:
  • Phone: 775-348-4790
  • Fax: 775-348-5928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LADAWN MICHELLE TALBOTT
Title or Position: OWNER
Credential: M.D.
Phone: 775-348-4790