MEDICARE: TAYLOR BURTON PA-C

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
1	363A00000X	Physician Assistant	1867	WV

General Provider Information

NPI Number	:	1427441336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR BURTON PA-C

Provider Business Mailing Address
First Line	:	1320 MAPLEWOOD AVE
Second Line	:
City	:	RONCEVERTE
State	:	WV
Zip	:	24970-8016
Country	:	US
Telephone Number	:	304-753-9100
Fax Number	:	304-753-9353

Provider Business Practice Location Address
First Line	:	3115 SENECA TRL S
Second Line	:
City	:	PETERSTOWN
State	:	WV
Zip	:	24963-5040
Country	:	US
Telephone Number	:	304-753-9100
Fax Number	:	304-753-9353

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2015
Last Update Date	:	11/16/2023

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Directions to “ TAYLOR BURTON PA-C” Practice Location

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