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Individual

ELIZABETH A TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
3055 N LAKE CT, NEWBURGH, IN 47630
(812) 454-7872
Mailing address
3055 N LAKE CT, NEWBURGH, IN 47630
(812) 454-7872

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
02001727A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
137600D
RENDERING PROVIDER
IN
05
200092520
IN
Enumeration date
06/14/2006
Last updated
10/19/2016
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