Provider Demographics
NPI:1962789339
Name:TALBOTT, EDGAR FRANKLIN III (PHARMD)
Entity type:Individual
Prefix:
First Name:EDGAR
Middle Name:FRANKLIN
Last Name:TALBOTT
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:1033 COLT HOLLOW ROAD
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614-0245
Mailing Address - Country:US
Mailing Address - Phone:276-220-5537
Mailing Address - Fax:
Practice Address - Street 1:1060 DRAGON RD
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:VA
Practice Address - Zip Code:24631-9210
Practice Address - Country:US
Practice Address - Phone:186-693-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-13
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014712183500000X
VA0202209375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist