Individual
DR. REBECCA ANNE TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 MAGNOLIA WAY, SUITE 101, AUGUSTA, GA 30909-9483
(706) 922-6600
(706) 650-0239
Mailing address
PO BOX 2510, EVANS, GA 30809-2510
(706) 922-8251
(706) 922-6695
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47268
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00825272A
—
GA
01
—
047268
LICENSE
—
01
—
10056668
AMERIGROUP
GA
01
—
338184
WELLCARE
GA
01
—
CH0654
RR MEDICARE GROUP PIN
GA
05
—
G47268
—
SC
Enumeration date
06/07/2006
Last updated
04/17/2026
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