Kelley Tallman, Jane E
Kelley Tallman, Jane E is an individual health care provider with primary practice located at 100 Taylor Ln , Ronceverte WV 24970-1337. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Kelley Tallman, Jane E can be contacted via phone (304) 647-3434.Contact Information
Primary practice address
100 Taylor Ln
Ronceverte WV 24970-1337
Phone: (304) 647-3434
Fax: (304) 647-9789
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 1770 | West Virginia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 1770 | West Virginia |
Profile Details
| NPI number | 1700877412 |
|---|---|
| LBN Legal business name | Kelley Tallman, Jane E |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Apr 24th, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700877412 | NPPES |
| West Virginia | Other | 001721727 | BC |
| West Virginia | Other | 1048076 | BC |
| West Virginia | MEDICAID | 5600556000 | BC |
| West Virginia | Other | P00049529 | BC |
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