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Individual

MARK E TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 CLYBURN PL, AIKEN, SC 29801-4193
(803) 380-7000
(803) 502-4248
Mailing address
1000 CLYBURN PL, AIKEN, SC 29801-4193
(803) 380-7000
(803) 502-4248

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
055797
GA
207Q00000X
Family Medicine Physician
Primary
37534
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000467519A
GA
05
000471809A
GA
05
000471809B
GA
05
000471809C
GU
01
10060509
AMERIGROUP
GA
01
341628
WELLCARE MCAID
GA
01
341629
WELLCARE
GA
01
341630
WELLCARE MCAID
GA
01
342410
WELLCARE MCAID
GA
05
980939645C
GA
05
980939645E
GA
05
980939645F
GA
05
980939645G
GA
Enumeration date
08/18/2005
Last updated
10/19/2015
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