Individual
DR. ANGELLA MARIE TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2201 CONCORD AVE NW, STE 100, CORYDON, IN 47112-2060
(812) 738-1200
(812) 738-1710
Mailing address
PO BOX 38, CORYDON, IN 47112-0038
(812) 738-4251
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01061972A
IN
208000000X
Pediatrics Physician
Primary
40534
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200847430
—
IN
05
—
7100206000
—
KY
Enumeration date
09/20/2006
Last updated
12/30/2020
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