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General NPI Number Information
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NPI Number | 1942309455
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Entity Type | Individual
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Provider Name | JOHN D TALBOTT DO
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 01/23/2014
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Provider Practice Location Address
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Address Line | 560 W MITCHELL ST STE 400 MHVS CARDIOVASCULAR & THORACIC SURGER
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City | PETOSKEY
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State | MI
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Zip | 49770-2274
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Country | US
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Telephone | 231-487-4950
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Fax | 231-487-4951
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Provider Business Mailing Address
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Address Line | 416 CONNABLE
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City | PETOSKEY
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State | MI
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Zip | 49770
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Country | US
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Telephone | 231-487-7129
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Fax | 231-487-3082
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 5101010171
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License Number State | MI
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