Individual
BRUCE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4258 US HIGHWAY 80 W, SELMA, AL 36701-2202
(334) 874-8800
(334) 874-7700
Mailing address
4258 US HIGHWAY 80 W, SELMA, AL 36701-2202
(334) 874-8800
(334) 874-7700
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
24464
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01D1015085
CLIA
AL
01
—
51516872
BC/BS
AL
05
—
529916810
—
AL
Enumeration date
06/29/2006
Last updated
03/07/2023
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