Individual
DORRENCE CONEY TALBUT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5757 MONCLOVA RD, #2, MAUMEE, OH 43537-1863
(419) 893-7607
(419) 893-7608
Mailing address
5757 MONCLOVA RD, #2, MAUMEE, OH 43537-1863
(419) 893-7607
(419) 893-7608
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
3502 0459T
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335611
—
MI
01
—
448094
WORKERS COMP
OH
05
—
47069
—
OH
Enumeration date
07/20/2005
Last updated
07/08/2007
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