Organization
TAYLOR REGIONAL MEDICAL GROUP,LLC
Active
Other names
Taylor Regional Urology
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA WALDRON (COORDINATOR)
(270) 465-3561
Entity
Organization
Contact information
Practice address
1698 OLD LEBANON RD, SUITE 3B, CAMPBELLSVILLE, KY 42718
(270) 789-2445
Mailing address
1698 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9662
(270) 789-6087
(270) 789-6119
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100071450
—
KY
05
—
7100079630
—
KY
05
—
7100598820
—
KY
Enumeration date
10/17/2008
Last updated
05/27/2025
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