Healthcare Provider Details

I. General information

NPI: 1104052059
Provider Name (Legal Business Name): LAURA LEE TAYLOR M.D.,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 05/28/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12935 HIGHWAY 231 431 N
HAZEL GREEN AL
35750-8631
US

IV. Provider business mailing address

12935 HIGHWAY 231 431 N
HAZEL GREEN AL
35750-8631
US

V. Phone/Fax

Practice location:
  • Phone: 256-828-6766
  • Fax: 866-782-9553
Mailing address:
  • Phone: 256-828-6766
  • Fax: 256-261-7877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28238
License Number StateAL

VIII. Authorized Official

Name: DR. LAURA LEE TAYLOR I
Title or Position: OWNER
Credential: M.D.
Phone: 256-828-6766