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General NPI Number Information
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NPI Number | 1386820553
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Entity Type | Individual
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Provider Name | RANDOLPH TAYLOR II M.D
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Gender | Male
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 4441 ATLANTA RD SE STE 216
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City | SMYRNA
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State | GA
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Zip | 30080-6442
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Country | US
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Telephone | 470-956-4120
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Fax |
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Provider Business Mailing Address
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Address Line | 4441 ATLANTA RD SE STE 216
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City | SMYRNA
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State | GA
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Zip | 30080-6442
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Country | US
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Telephone | 470-956-4120
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Fax | 678-842-5535
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | P7580
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME 113093
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 83783
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License Number State | GA
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