Individual
MARY A. TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8001 YOUREE DR, SUITE 320, SHREVEPORT, LA 71115-2302
(318) 212-2870
(318) 212-2875
Mailing address
8001 YOUREE DR, SUITE 320, SHREVEPORT, LA 71115-2302
(318) 212-2870
(318) 212-2875
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
021137
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1973017
—
LA
01
—
P00256934
MEDICARE RR
LA
Enumeration date
05/17/2006
Last updated
05/22/2013
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