Provider Demographics
NPI:1992150692
Name:TALLANT, CAITLIN (MD)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:TALLANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:USS ARLINGTON (LPD 24)
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09564-1706
Mailing Address - Country:US
Mailing Address - Phone:757-567-1182
Mailing Address - Fax:
Practice Address - Street 1:USS ARLINGTON (LPD 24)
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09564-1706
Practice Address - Country:US
Practice Address - Phone:757-567-1182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-01
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101263046208D00000X, 171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice