Individual
JOHN STAFFORD TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 MARK DR, EDENTON, NC 27932-1756
(252) 482-5171
(252) 482-5173
Mailing address
PO BOX 1210, EDENTON, NC 27932-1210
(252) 482-5171
(252) 482-5173
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9601084
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8982105
—
NC
Enumeration date
10/20/2005
Last updated
12/16/2009
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