Organization
J. ANDRE TAYLOR, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK ANDRE TAYLOR M.D. (PRESIDENT)
(256) 381-8200
Entity
Organization
Contact information
Practice address
1100 S MONTGOMERY AVE, SHEFFIELD, AL 35660-6330
(256) 381-8200
(256) 383-6753
Mailing address
1100 S MONTGOMERY AVE, SHEFFIELD, AL 35660-6330
(256) 381-8200
(256) 383-6753
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12828
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051554360TAY
BCBS OF ALABAMA
AL
05
—
051554360TAY
—
AL
01
—
DA3810
RAILRROAD MEDICARE
AL
Enumeration date
11/28/2006
Last updated
10/20/2009
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