Individual
ELLIOTT TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 W TERRELL AVE STE K230, FORT WORTH, TX 76104-3104
(817) 250-4906
Mailing address
716 JENKINS RD, SHREVEPORT, LA 71107-2215
(318) 489-5173
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34060
FL
207R00000X
Internal Medicine Physician
Primary
U5824
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/24/2021
Last updated
07/17/2024
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