Individual
DR. YOLANDA TAYLOR-ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2401 MEDICAL CENTER PKWY, SELMA, AL 36701-7756
(334) 872-2321
(334) 872-2391
Mailing address
PO BOX 650, SELMA, AL 36702-0650
(334) 872-2321
(334) 872-2391
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-A03-TA-575
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000046510
—
AL
01
—
51504510
BLUE AND CROSS SHEILD NUM
AL
01
—
S-A03TA575
LICENSE NUMBER
AL
Enumeration date
08/25/2006
Last updated
07/09/2007
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