Individual
DR. JEFFERY Y. TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
431 SECURITY SQ, GULFPORT, MS 39507-1922
(228) 896-4325
(228) 896-5787
Mailing address
1122 DEMOURELLE RD, PASS CHRISTIAN, MS 39571-4224
(228) 452-0777
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2649
MS
1223P0300X
Periodontics
PER24293
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
696993
ACTIVE DUTY MILITARY
—
Enumeration date
10/23/2006
Last updated
07/08/2007
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