Healthcare Provider Details

I. General information

NPI: 1033670427
Provider Name (Legal Business Name): TAYLOR ELIZABETH ANDERSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE # ML2008
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE ML2008
CINCINNATI OH
45229-3019
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-7966
  • Fax:
Mailing address:
  • Phone: 513-636-7966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number250759
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number66182
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0000066182
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.153636
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: