Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 44957 | AZ |
N | 111NI0900X | Internist | 44957 | AZ |
Y | 207RG0300X | Geriatric Medicine | 44957 | AZ |
NPI | 1114040862 |
---|---|
Provider Name | Dr. Talissa Beth Adkison |
First Address | Phoenix, AZ 85014-5698 |
Second Address | Phoenix, AZ 85014-5698 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 05/03/2020 |