1114467891 NPI number — DR. DAWN E DEWITT TALBOT MD, MACP, FRACP

Table of content: DR. DAWN E DEWITT TALBOT MD, MACP, FRACP (NPI 1114467891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114467891 NPI number — DR. DAWN E DEWITT TALBOT MD, MACP, FRACP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEWITT TALBOT
Provider First Name:
DAWN
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MACP, FRACP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEWITT
Provider Other First Name:
DAWN
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD, MACP, FRACP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1114467891
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MULTICARE ROCKWOOD CLINIC ENDOCRINOLOGY AND DIABETES ED
Provider Second Line Business Mailing Address:
400 E 5TH AVENUE
Provider Business Mailing Address City Name:
SPOKANE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99202-2519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-342-3450
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MULTICARE ROCKWOOD ENDOCRINOLOGY & DIABETES EDUCATION
Provider Second Line Business Practice Location Address:
400 EAST 5TH AVENUE, SUITE 4 (WEST)
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-342-3450
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD00029962 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)