Organization
TAYLOR REGIONAL MEDICAL GROUP, LLC
Active
Other names
Taylor Regional Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA ANN WALDRON (COORDINATOR)
(270) 465-3561
Entity
Organization
Contact information
Practice address
125 KINGSWOOD DR, CAMPBELLSVILLE, KY 42718-9634
(270) 789-1112
(270) 789-6176
Mailing address
1698 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9662
(270) 789-6087
(270) 789-6119
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
208000000X
Pediatrics Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100450550
—
KY
05
—
7100450940
—
KY
05
—
7100948510
—
KY
05
—
7100977040
—
KY
Enumeration date
10/13/2016
Last updated
07/08/2025
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