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Individual

MR. LARRY WAYNE TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6554 AARON DR, FAIRFIELD, AL 35214
(205) 786-5022
(205) 786-5028
Mailing address
2147 RIVERCHASE OFFICE RD, BIRMINGHAM, AL 35244-1836
(205) 403-8902
(205) 982-7882

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO453
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000027610
AL
01
051027665
BLUE CROSS BLUE SHIELD
AL
01
080143157
RAILROAD MEDICARE
AL
Enumeration date
03/17/2006
Last updated
09/20/2012
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