MEDICARE: DR. LARRY EDWARD TAYLOR M.D.

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	174400000X	Specialist	23230	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00163198	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000340508	OTHER	KY	BCBS/WOMENS WELLNESS CTR
3	1398060	OTHER	KY	MAILHANDLERS
5	C07214	OTHER	KS	CHI

General Provider Information

NPI Number	:	1457386609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY EDWARD TAYLOR M.D.

Provider Business Mailing Address
First Line	:	1705 FOREST DR
Second Line	:
City	:	CORBIN
State	:	KY
Zip	:	40701-2354
Country	:	US
Telephone Number	:	606-528-9772
Fax Number	:	606-528-9242

Provider Business Practice Location Address
First Line	:	1705 FOREST DR
Second Line	:
City	:	CORBIN
State	:	KY
Zip	:	40701-2354
Country	:	US
Telephone Number	:	606-528-9772
Fax Number	:	606-528-9242

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	02/19/2008

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Directions to “ DR. LARRY EDWARD TAYLOR M.D.” Practice Location

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