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General NPI Number Information
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NPI Number | 1710567706
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Entity Type | Organization
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Legal Business Name | TAYLOR REGIONAL MEDICAL GROUP LLC
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 219 MEADER ST
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-2639
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Country | US
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Telephone | 270-789-6112
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Fax |
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Provider Business Mailing Address
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Address Line | 67 KINGSWOOD DR
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9647
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Country | US
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Telephone | 270-789-6087
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Fax | 270-789-6119
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL EVERETT
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Credential |
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Telephone | 270-465-3561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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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 |
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License Number State |
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