Healthcare Provider Details

I. General information

NPI: 1013470566
Provider Name (Legal Business Name): TAYLOR DAVID WACHS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

IV. Provider business mailing address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

V. Phone/Fax

Practice location:
  • Phone: 334-749-3411
  • Fax:
Mailing address:
  • Phone: 334-749-3411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberDO.4119
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO.4119
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: