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General NPI Number Information
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NPI Number | 1114013315
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Entity Type | Organization
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Legal Business Name | TAYLOR INTERNAL MEDICINE OF SELMA, P.C.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 4258 US HIGHWAY 80 W
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City | SELMA
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State | AL
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Zip | 36701-2202
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Country | US
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Telephone | 334-874-8800
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Fax | 334-874-7700
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Provider Business Mailing Address
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Address Line | 4258 US HIGHWAY 80 W
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City | SELMA
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State | AL
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Zip | 36701-2202
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Country | US
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Telephone | 334-874-8800
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Fax | 334-874-7700
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Authorized Official
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Title or Position | PHYSICIAN
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Name | BRUCE EDWARD TAYLOR
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Credential | M.D.
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Telephone | 334-874-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 24464
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License Number State | AL
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