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Individual

JACK ANDRE TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1120 S JACKSON HWY, SUITE 300, SHEFFIELD, AL 35660-5777
(256) 383-4447
(256) 383-9643
Mailing address
1120 S JACKSON HWY, SUITE 300, SHEFFIELD, AL 35660-5777
(256) 383-4447
(256) 383-9643

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12828
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051554360TAY
BC/BS OF ALABAMA
AL
05
051554360TAY
AL
01
DA3810
RAILROAD MEDICARE
AL
Enumeration date
01/12/2006
Last updated
03/06/2015
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