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NPI Code Detail

MEDICARE: TAYLOR B WOOTTON MD

MEDICARE: TAYLOR B WOOTTON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician48047TN
2208M00000XHospitalist PhysicianS1735TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407173016
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR B WOOTTON MD
Provider Business Mailing Address
First Line : PO BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-7208
Country : US
Telephone Number : 214-636-5555
Fax Number : 423-778-3146
Provider Business Practice Location Address
First Line : 6201 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-2147
Country : US
Telephone Number : 214-633-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2010
Last Update Date : 09/04/2019

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Directions to “ TAYLOR B WOOTTON MD” Practice Location

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