Individual
DWAYNE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3708 NORTHSIDE DR BLDG B, MACON, GA 31210-2404
(478) 633-6115
(478) 633-1947
Mailing address
3708 NORTHSIDE DR BLDG B, MACON, GA 31210-2404
(478) 633-6115
(478) 633-1947
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN201624
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN201624
GA NP LICENSE
GA
Enumeration date
05/14/2015
Last updated
10/10/2025
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