Organization
KEITH E. TAYLOR, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH TAYLOR O.D. (OWNER)
(781) 631-2182
Entity
Organization
Contact information
Practice address
166 ATLANTIC AVE, MARBLEHEAD, MA 01945-2911
(781) 631-2182
Mailing address
166 ATLANTIC AVE, MARBLEHEAD, MA 01945-2911
(781) 631-2182
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0348988
—
MA
Enumeration date
10/30/2014
Last updated
10/30/2014
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