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General NPI Number Information
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NPI Number | 1871271023
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Entity Type | Individual
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Provider Name | TAYLOR CORYN ELDRED OD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2023
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 122 BEN CASEY DR
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City | FORT MILL
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State | SC
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Zip | 29708-6593
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Country | US
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Telephone | 803-396-3937
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Fax | 803-396-3945
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Provider Business Mailing Address
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Address Line | 122 BEN CASEY DR
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City | FORT MILL
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State | SC
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Zip | 29708-6593
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Country | US
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Telephone | 315-391-2430
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC6417
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T009834
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License Number State | NY
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