Individual
JACOB MICHAEL TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(813) 343-5500
(813) 343-5506
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0010 02147
NC
363AS0400X
Surgical Physician Assistant
Primary
0010-02147
NC
Other
Enumeration date
01/04/2010
Last updated
04/13/2021
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