Individual
LEE B TAYLOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3021 REIDVILLE RD, SPARTANBURG, SC 29301-5643
(864) 576-9201
(864) 576-6584
Mailing address
3021 REIDVILLE RD, SPARTANBURG, SC 29301-5643
(864) 576-9201
(864) 576-6584
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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