# DANIEL L TALLERICO MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316097108
- **Authorized official:** DR. DANIEL TALLERICO MD (DOCTOR)
- **Authorized official phone:** (405) 471-6249

## Contact information

- **Practice address:** 3863 S BOULEVARD ST, SUITE 100, EDMOND, OK 73013-5519
- **Practice address phone:** (405) 471-6249
- **Practice address fax:** (405) 471-6255
- **Mailing address:** 3863 S BOULEVARD, SUITE 100, EDMOND, OK 73013
- **Mailing address phone:** (405) 471-6249
- **Mailing address fax:** (405) 471-6255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 10585 | OK | Yes |

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 08/22/2020