Organization
TAYLOR REGIONAL MEDICAL GROUP LLC
Active
Other names
Taylor Regional ENT
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA ANN WALDRON (COORDINATOR)
(270) 465-3561
Entity
Organization
Contact information
Practice address
105 GREENBRIAR DR, SUITE A, CAMPBELLSVILLE, KY 42718-9617
(270) 465-3595
(270) 789-2044
Mailing address
1698 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-3319
(270) 789-6087
(270) 789-6119
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
237600000X
Audiologist-Hearing Aid Fitter
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100149690
—
KY
05
—
7100157910
—
KY
05
—
7100311680
—
KY
Enumeration date
12/28/2010
Last updated
05/27/2025
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