Healthcare Provider Details

I. General information

NPI: 1790534949
Provider Name (Legal Business Name): DR. JOEL TALLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ARLINGTON AVE
TOLEDO OH
43614-2598
US

IV. Provider business mailing address

3000 ARLINGTON AVE
TOLEDO OH
43614-2598
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-1940
  • Fax:
Mailing address:
  • Phone: 419-383-1940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03446929
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34790
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026040888
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: