Tallon, M Teresa

Tallon, M Teresa is an sole proprietor health care provider with primary practice located at 2821 E Dupont Rd , Fort Wayne IN 46825-1668. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Tallon, M Teresa can be contacted via phone (260) 497-0602.

Contact Information

Primary practice address
2821 E Dupont Rd Fort Wayne IN 46825-1668
Phone: (260) 497-0602
Fax: (260) 497-0657
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01039505 Indiana
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 01039505 Indiana

Profile Details

NPI number 1649262155
LBN Legal business name Tallon, M Teresa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 19th, 2005
Last updated Aug 23rd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649262155 NPPES
Indiana MEDICAID 100104150A
Indiana Other 000000089022

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