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Organization
TAYLOR MADE MEDICAL GROUP LLC
Active
Organization
TAYLOR MADE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEEANN TAYLOR DNP (MANAGER)
(702) 800-0985
Entity
Organization
Contact information
Practice address
3301 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1835
(702) 800-0985
Mailing address
3301 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1835
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
03/22/2021
Last updated
03/22/2021
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