Individual
MR. ELDRIDGE L TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
225 JASMINE DR, JACKSON, MS 39212-3283
(601) 212-9272
Mailing address
225 JASMINE DR, JACKSON, MS 39212-3283
(601) 212-9272
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R864321
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03551301
—
MS
Enumeration date
11/23/2010
Last updated
08/06/2013
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