Individual
JUDITH TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2410 ATHERHOLT RD, LYNCHBURG, VA 24501-2148
(434) 528-2212
Mailing address
1204 FENWICK DR, LYNCHBURG, VA 24502-2112
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002378
VA
363AS0400X
Surgical Physician Assistant
0110002378
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010338263
—
VA
Enumeration date
10/13/2006
Last updated
10/20/2016
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