Individual
GERALD TAYLOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3200 MACCORKLE AVE SE, STE B16, CHARLESTON, WV 25304
(304) 388-5848
(304) 388-9654
Mailing address
4605 MACCORKLE AVENUE, SW, THS PHYSICIAN PARTNERS, INC.-ADMIN OFC, SOUTH CHARLESTON, WV 25309
(304) 414-4800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01311
WV
363AM0700X
Medical Physician Assistant
Primary
1311
WV
Other
Enumeration date
02/21/2008
Last updated
10/31/2018
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