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General NPI Number Information
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NPI Number | 1295893857
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Entity Type | Individual
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Provider Name | STANLEY DOUGLAS TAYLOR MD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 1201 COUNTRY CLUB RD
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6807
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Country | US
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Telephone | 910-347-7773
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Fax | 910-347-7792
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Provider Business Mailing Address
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Address Line | 504 SANAL COURT
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City | JACKSONVILLE
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State | NC
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Zip | 28540
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Country | US
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Telephone | 910-347-7773
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Fax | 910-347-7792
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 23340
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License Number State | NC
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