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Organization
TAYLOR REGIONAL MEDICAL GROUP,LLC
Active
Organization
TAYLOR REGIONAL MEDICAL GROUP,LLC
Active
Other names
Taylor Regional Urology
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA WALDRON (COORDINATOR)
(270) 465-3561
Entity
Organization
Contact information
Practice address
1698 OLD LEBANON RD, SUITE 3B, CAMPBELLSVILLE, KY 42718
(270) 789-2445
Mailing address
1698 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9662
(270) 789-6087
(270) 789-6119
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100071450
—
KY
05
—
7100079630
—
KY
05
—
7100598820
—
KY
Enumeration date
10/17/2008
Last updated
05/27/2025
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