Healthcare Provider Details

I. General information

NPI: 1720549744
Provider Name (Legal Business Name): TAYLOR KILLIAN MASTERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2019
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 TROTWOOD AVE STE 400
COLUMBIA TN
38401-6436
US

IV. Provider business mailing address

1222 TROTWOOD AVE STE 603
COLUMBIA TN
38401-6410
US

V. Phone/Fax

Practice location:
  • Phone: 931-490-1295
  • Fax:
Mailing address:
  • Phone: 931-490-1295
  • Fax: 727-553-7340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number68478
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: