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Individual

GRANT D TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2204 PAVILION DR STE 310, KINGSPORT, TN 37660-4653
(423) 246-4155
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD39734
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3329892
TN
Enumeration date
04/18/2006
Last updated
02/14/2024
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