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General NPI Number Information
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NPI Number | 1487607578
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Entity Type | Individual
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Provider Name | EARLE M TAYLOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 610 FERNCREST DR STE B
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City | SANDERSVILLE
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State | GA
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Zip | 31082-1863
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Country | US
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Telephone | 478-552-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 508 W ELM ST
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City | WRIGHTSVILLE
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State | GA
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Zip | 31096-1224
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Country | US
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Telephone | 478-864-3448
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Fax | 478-864-1288
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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 | 025298
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License Number State | GA
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