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NPI Code Detail

MEDICARE: DR. TY M TALLMAN N.M.D.

MEDICARE: DR. TY M TALLMAN N.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1202D00000XIntegrative Medicine Physician04-792AZ
2202D00000XIntegrative Medicine Physician4461OR
32083B0002XObesity Medicine (Preventive Medicine) Physician04-792AZ
4208D00000XGeneral Practice Physician04-792AZ
5175F00000XNaturopath04-792AZ

General Provider Information

NPI Number : 1770614307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TY M TALLMAN N.M.D.
Provider Business Mailing Address
First Line : 11445 E VIA LINDA
Second Line : STE 2 #604
City : SCOTTSDALE
State : AZ
Zip : 85259-2655
Country : US
Telephone Number : 480-219-2624
Fax Number : 480-629-5651
Provider Business Practice Location Address
First Line : 1910 S STAPLEY DR STE 120
Second Line :
City : MESA
State : AZ
Zip : 85204-6676
Country : US
Telephone Number : 480-219-2624
Fax Number : 888-210-1237
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 07/14/2025

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