Provider Demographics
NPI:1053348011
Name:TALBOT COUNTY BOARD OF HEALTH
Entity type:Organization
Organization Name:TALBOT COUNTY BOARD OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZSOLT
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPPANYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-321-6300
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:TALBOTTON
Mailing Address - State:GA
Mailing Address - Zip Code:31827-0247
Mailing Address - Country:US
Mailing Address - Phone:706-665-8561
Mailing Address - Fax:706-665-3979
Practice Address - Street 1:1073 WOODLAND HWY
Practice Address - Street 2:
Practice Address - City:TALBOTTON
Practice Address - State:GA
Practice Address - Zip Code:31827
Practice Address - Country:US
Practice Address - Phone:706-665-8561
Practice Address - Fax:706-665-3979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00647193AMedicaid
GA00052082RMedicaid
GA00058726OMedicaid
GA00457729AMedicaid
GA00457729AMedicaid