Individual
MRS. TAYLOR JOHNSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3999 DUTCHMANS LN STE 7B, LOUISVILLE, KY 40207-4742
(502) 896-4711
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
TC866
KY
363A00000X
Physician Assistant
Primary
TC866
KY
363AM0700X
Medical Physician Assistant
TC866
KY
Other
Enumeration date
09/24/2019
Last updated
10/27/2020
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