Individual
DR. WALLER L TAYLOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1821 OLD DONATION PARKWAY, SUITE 1, VIRGINIA BEACH, VA 23454-3033
(757) 481-6954
(757) 481-1965
Mailing address
1821 OLD DONATION PARKWAY, SUITE 1, VIRGINIA BEACH, VA 23454-3033
(757) 481-6954
(757) 481-1965
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101018250
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
065727
ANTHEM
—
01
—
1099195
FIRST HEALTH
—
01
—
6212000
DAVIS VISION
—
01
—
77473
SENTARA
—
05
—
890616R
—
NC
01
—
918190
EYE MED
—
Enumeration date
08/31/2006
Last updated
07/08/2007
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