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Individual
LEE B TAYLOR JR.
Active
Individual
LEE B TAYLOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9525
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095257
—
SC
01
—
GP4988
MEDICAID GROUP NO.
SC
01
—
P00683616
RR MEDICARE PTAN
SC
Enumeration date
05/27/2006
Last updated
08/18/2023
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