Healthcare Provider Details

I. General information

NPI: 1336147321
Provider Name (Legal Business Name): NATALIE LIZETTE TALBOO-DILLON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 HUGHES DR STE 310
TOLEDO OH
43606-3845
US

IV. Provider business mailing address

1 SEAGATE STE 800
TOLEDO OH
43604-1558
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-3858
  • Fax: 419-480-8701
Mailing address:
  • Phone: 330-673-6988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number50001437
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: