Individual
BENJAMIN H TAYLOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1120 15TH STREET, AUGUSTA, GA 30912
(706) 721-4951
(706) 721-7941
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2650
(706) 724-6100
(706) 722-5187
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003109
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056PA
—
SC
05
—
1000002361A
—
GA
Enumeration date
10/04/2006
Last updated
07/08/2007
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