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Organization

JOHN L. TAYLOR, JR., M.D., PA

Active
Parent organization
JOHN L. TAYLOR, JR., M.D., PA
Other names
Plantation Gynecology
Organization subpart
Yes

Provider details

NPI number
Legal business name
JOHN L. TAYLOR, JR., M.D., PA
Authorized official
CHERYL R SUMNER (OFFICE MANAGER)
(229) 225-9929
Entity
Organization

Contact information

Practice address
814 GORDON AVENUE, THOMASVILLE, GA 31792
(229) 225-9805
(229) 225-9915
Mailing address
814 GORDON AVENUE, THOMASVILLE, GA 31792
(229) 225-9805
(229) 225-9915

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
015693
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000269882B
GA
01
21168656803
GREAT WEST HEALTHCARE
GA
01
257723363
CHAMPUS/TRICARE
GA
01
656597
UNITED HEALTHCARE
GA
01
672327
BCBS
GA
01
9624285
SOUTHCARE
GA
Enumeration date
05/27/2006
Last updated
08/25/2009
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