MEDICARE: DR. ROY NORMAN TAYLOR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	13792	SC
2	207VG0400X	Gynecology Physician	13792	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396712345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROY NORMAN TAYLOR M.D.

Provider Business Mailing Address
First Line	:	1721 EBENEZER RD
Second Line	:	SUITE 145
City	:	ROCK HILL
State	:	SC
Zip	:	29732-4103
Country	:	US
Telephone Number	:	803-328-2401
Fax Number	:	803-328-1030

Provider Business Practice Location Address
First Line	:	1721 EBENEZER RD
Second Line	:	SUITE 145
City	:	ROCK HILL
State	:	SC
Zip	:	29732-4103
Country	:	US
Telephone Number	:	803-328-2401
Fax Number	:	803-328-1030

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	03/22/2022

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