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General NPI Number Information
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NPI Number | 1831106988
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Entity Type | Individual
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Provider Name | LEONARD MICHAEL TALARICO DPM
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 02/12/2022
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Provider Practice Location Address
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Address Line | 140 TRADERS WAY
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City | POOLER
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State | GA
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Zip | 31322-4035
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Country | US
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Telephone | 912-330-8885
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Fax | 912-330-8858
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Provider Business Mailing Address
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Address Line | 140 TRADERS WAY
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City | POOLER
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State | GA
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Zip | 31322-4035
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Country | US
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Telephone | 912-330-8885
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Fax | 912-330-8858
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 945
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 945
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License Number State | GA
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