Organization
TAYLOR REGIONAL MEDICAL GROUP, LLC
Active
Other names
Taylor Regional Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA ANN WALDRON (COORDINATOR)
(270) 465-3561
Entity
Organization
Contact information
Practice address
1698 OLD LEBANON RD, SUITE 2A, CAMPBELLSVILLE, KY 42718-9662
(270) 465-3561
(270) 789-6119
Mailing address
1698 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9662
(270) 465-3561
(270) 789-6119
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65944449
—
KY
05
—
7100428810
—
KY
05
—
7100477070
—
KY
Enumeration date
07/28/2006
Last updated
05/27/2025
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