Individual
JOHN TAYLOR AUTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MEDICAL PARK DR, CHESTER, SC 29706-9769
(803) 581-3151
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036142175
IL
207P00000X
Emergency Medicine Physician
34.013414
OH
207P00000X
Emergency Medicine Physician
Primary
83236
SC
Other
Enumeration date
04/09/2014
Last updated
10/26/2020
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