Healthcare Provider Details

I. General information

NPI: 1639874365
Provider Name (Legal Business Name): TAYLOR BROOKE DAUGHRITY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 8TH ST STE 208
MURRAY KY
42071-2400
US

IV. Provider business mailing address

300 S 8TH ST STE 208
MURRAY KY
42071-2400
US

V. Phone/Fax

Practice location:
  • Phone: 270-759-9223
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTP972
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: