Individual
RANDOLPH H TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 THOMAS ROAD, SUITE117, WEST MONROE, LA 71291
(319) 329-8194
(318) 329-8196
Mailing address
102 THOMAS ROAD, SUITE 117, WEST MONROE, LA 71291
(319) 329-8194
(318) 329-8196
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
013943
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1330744
—
LA
01
—
H09001
VANTAGE HEALTH PLAN,INC
LA
Enumeration date
06/16/2005
Last updated
02/11/2014
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