Individual
DR. TERRY W TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 W IOWA ST, EVANSVILLE, IN 47710-1721
(812) 424-2020
(812) 424-3000
Mailing address
201 W IOWA ST, EVANSVILLE, IN 47710-1721
(812) 424-2020
(812) 424-3000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01020881
IN
207W00000X
Ophthalmology Physician
036085856
IL
207W00000X
Ophthalmology Physician
33096
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042322
ANTHEM
—
05
—
100242690
—
IN
01
—
116701
HEALTHLINK
—
01
—
4005761
AETNA
—
05
—
64347057
—
KY
Enumeration date
09/19/2005
Last updated
02/19/2013
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