MEDICARE: LLOYD JEFF TAYLOR PA

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	363A00000X	Physician Assistant	101553	NC

General Provider Information

NPI Number	:	1932155629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LLOYD JEFF TAYLOR PA

Provider Business Mailing Address
First Line	:	1509 E INNES ST
Second Line	:	SUITE B
City	:	SALISBURY
State	:	NC
Zip	:	28146-6018
Country	:	US
Telephone Number	:	704-738-2245
Fax Number	:	704-738-2246

Provider Business Practice Location Address
First Line	:	1509 E INNES ST
Second Line	:	SUITE B
City	:	SALISBURY
State	:	NC
Zip	:	28146-6018
Country	:	US
Telephone Number	:	704-738-2245
Fax Number	:	704-738-2246

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	04/17/2014

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