Individual
MRS. CHARLENE M TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
3017 13TH ST, GULFPORT, MS 39501-1833
(228) 863-6592
(228) 863-1747
Mailing address
13430 TARA HILLS DR, GULFPORT, MS 39503-2332
(228) 863-6592
(228) 863-1747
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A2774
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
512I640011
MEDICARE PROVIDER IDENTIFICATION NUMBER
MS
Enumeration date
08/24/2006
Last updated
11/09/2016
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