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General NPI Number Information
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NPI Number | 1124241336
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Entity Type | Individual
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Provider Name | KELLEY L TAYLOR MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 225B WINTON M BLOUNT LOOP
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City | MONTGOMERY
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State | AL
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Zip | 36117-3507
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Country | US
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Telephone | 334-623-6228
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Fax | 334-265-9136
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Provider Business Mailing Address
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Address Line | 225B WINTON M BLOUNT LOOP
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City | MONTGOMERY
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State | AL
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Zip | 36117-3507
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Country | US
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Telephone | 334-623-6228
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Fax | 334-265-9136
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 42108
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 42108
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License Number State | TN
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