Organization
JERRY A TAYLOR DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY ALAN TAYLOR D.O. (PRESIDENT)
(248) 569-0334
Entity
Organization
Contact information
Practice address
20905 GREENFIELD RD, NORTHLAND MEDICAL BUILDING SUITE 602, SOUTHFIELD, MI 48075-5360
(248) 569-0334
(248) 569-0818
Mailing address
20905 GREENFIELD RD, NORTHLAND MEDICAL BUILDING SUITE 602, SOUTHFIELD, MI 48075-5360
(248) 569-0334
(248) 569-0818
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1065476-11
—
MI
Enumeration date
09/14/2009
Last updated
09/14/2009
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