Individual
JEFFERY M TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4630 VILLAGE SQUARE DR, PADUCAH, KY 42001-7502
(270) 442-1671
(270) 442-7307
Mailing address
4630 VILLAGE SQUARE DR, PADUCAH, KY 42001-7502
(270) 442-1671
(270) 442-7307
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
39545
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000372438
ANTHEM BCBS
—
01
—
610706763
TRICARE
—
05
—
64103385
—
KY
05
—
7100053130
—
KY
01
—
P00226010
RAILROAD MEDICARE
—
Enumeration date
03/07/2006
Last updated
11/14/2018
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