Individual
TIMOTHY BLAKE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2412 N OAK ST, VALDOSTA, GA 31602-2567
(229) 244-1400
(229) 244-5512
Mailing address
2412 N OAK ST, VALDOSTA, GA 31602-2567
(229) 244-1400
(229) 244-5512
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN235794
GA
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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