Individual
TERRI L TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1020 W BUENA VISTA RD, EVANSVILLE, IN 47710-5150
(812) 423-3131
(812) 426-7020
Mailing address
1020 W BUENA VISTA RD, EVANSVILLE, IN 47710-5150
(812) 423-3131
(812) 426-7020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003870A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000211012
BCBS PROVIDER NUMBER
—
01
—
1417DT
LICENSE
KY
05
—
201249590
—
IN
05
—
77014173
—
KY
Enumeration date
09/17/2006
Last updated
02/20/2015
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