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General NPI Number Information
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NPI Number | 1508084997
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Entity Type | Individual
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Provider Name | RANDALL KEITH TAYLOR DMD
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Gender | Male
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 WHITNELL ST
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City | MURRAY
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State | KY
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Zip | 42071-2966
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Country | US
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Telephone | 270-753-9201
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Fax | 270-753-9271
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Provider Business Mailing Address
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Address Line | 700 WHITNELL ST PO BOX 1538
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City | MURRAY
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State | KY
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Zip | 42071-2966
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Country | US
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Telephone | 270-753-9201
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Fax | 270-753-9271
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 7119
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License Number State | KY
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