MEDICARE: BEVERLY D TAYLOR MD

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	207Q00000X	Family Medicine Physician	025053	GA

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	:	1609849843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY D TAYLOR MD

Provider Business Mailing Address
First Line	:	720 WESTVIEW DR SW STE 100
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-1458
Country	:	US
Telephone Number	:	404-736-1400
Fax Number	:	404-736-5274

Provider Business Practice Location Address
First Line	:	1513 CLEVELAND AVE BLDG 500
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-6903
Country	:	US
Telephone Number	:	404-752-1000
Fax Number	:	404-752-1191

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	05/13/2019

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Directions to “ BEVERLY D TAYLOR MD” Practice Location

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