Organization
SELMA NEPHROLOGY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS KENT TAYLOR MD (PRESIDENT)
(334) 874-6053
Entity
Organization
Contact information
Practice address
905 MEDICAL CENTER PKWY, SELMA, AL 36701-6746
(334) 874-6053
(334) 418-0726
Mailing address
PO BOX 384, SELMA, AL 36702-0384
(334) 874-6053
(334) 418-0726
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
9217
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051005679
BLUE CROSS PROVIDER #
AL
01
—
051075573
BLUE CROSS PROVIDER #
AL
01
—
51517691
BLUE CROSS PROVIDER #
AL
05
—
SE528700710
—
AL
05
—
TA000005679
—
AL
05
—
TA000075573
—
AL
05
—
TA009931425
—
AL
Enumeration date
02/28/2006
Last updated
04/20/2008
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