Individual
JUSTIN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
96 JONATHAN LUCAS ST, CHARLESTON, SC 29425-8900
(843) 792-4638
Mailing address
2461 SW 76TH LN, OCALA, FL 34476-6773
(352) 391-8770
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL92788
SC
Other
Enumeration date
04/01/2024
Last updated
06/30/2024
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