# TAYLOR REGIONAL MEDICAL GROUP,LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Taylor Regional Urology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740432053
- **Authorized official:** DEBRA WALDRON (COORDINATOR)
- **Authorized official phone:** (270) 465-3561

## Contact information

- **Practice address:** 1698 OLD LEBANON RD, SUITE 3B, CAMPBELLSVILLE, KY 42718
- **Practice address phone:** (270) 789-2445
- **Mailing address:** 1698 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9662
- **Mailing address phone:** (270) 789-6087
- **Mailing address fax:** (270) 789-6119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |
| 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

- **Enumeration date:** 10/17/2008
- **Last updated:** 05/27/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100071450 | — | KY |
| 05 | — | 7100079630 | — | KY |
| 05 | — | 7100598820 | — | KY |