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General NPI Number Information
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NPI Number | 1225707748
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Entity Type | Organization
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Legal Business Name | TAYLOR REGIONAL MEDICAL GROUP,LLC
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1858 OLD LEBANON RD
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9663
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Country | US
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Telephone | 270-465-0632
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Fax | 270-465-0539
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Provider Business Mailing Address
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Address Line | 1698 OLD LEBANON RD
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-3319
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Country | US
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Telephone | 270-789-6087
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Fax |
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Authorized Official
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Title or Position | COORDINATOR
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Name | DEBRA ANN WALDRON
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Credential |
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Telephone | 270-465-3561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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