Healthcare Provider Details

I. General information

NPI: 1730476284
Provider Name (Legal Business Name): TIFFANY D TAYLOR M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANY D COBB

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 01/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 STEPHENSON AVE SUITE A3
SAVANNAH GA
31405-5923
US

IV. Provider business mailing address

527 STEPHENSON AVE SUITE A3
SAVANNAH GA
31405-5923
US

V. Phone/Fax

Practice location:
  • Phone: 912-352-8530
  • Fax: 912-352-1423
Mailing address:
  • Phone: 912-352-8530
  • Fax: 912-352-1423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAUD003559
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: