=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679605307
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GEORGE W TAUSSIG DC PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/09/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 163 E LAKE BRANTLEY DRIVE
-----------------------------------------------------
City | LONGWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32779
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-862-2220
-----------------------------------------------------
Fax | 407-862-4330
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 163 E LAKE BRANTLEY DRIVE
-----------------------------------------------------
City | LONGWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32779
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-862-2220
-----------------------------------------------------
Fax | 407-862-4330
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. GEORGE WASHINGTON TAUSSIG JR.
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 407-862-2220
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH00006870
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------