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Individual
JANE E KELLEY TALLMAN
Active
Individual
JANE E KELLEY TALLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1770
WV
207Q00000X
Family Medicine Physician
Primary
1770
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721727
BC
WV
01
—
1048076
W COMP
WV
05
—
5600556000
—
WV
01
—
P00049529
RR MCARE
WV
Enumeration date
11/02/2005
Last updated
04/24/2009
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