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NPI Code Detail

MEDICARE: DR. KELLY L TAYLOR DC

MEDICARE:  DR. KELLY L TAYLOR  DC
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
1111N00000XChiropractorDC009040PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11601629OTHERPABCBS INDIVIDUA
212137700OTHERPAFEDERAL EMPLOYEES WC
31618705OTHERPABCBS GROUP
43645987OTHERPAAETNA
5201066981OTHERPACOMMERCIAL PAYORS

General Provider Information

NPI Number : 1578557617
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELLY L TAYLOR DC
Provider Business Mailing Address
First Line : 116 RIDGE VIEW RD
Second Line :
City : NEW KENSINGTON
State : PA
Zip : 15068-8345
Country : US
Telephone Number : 412-378-0057
Fax Number :
Provider Business Practice Location Address
First Line : 11616 FRANKSTOWN RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15235-3319
Country : US
Telephone Number : 412-704-5053
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2005
Last Update Date : 01/23/2024

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Directions to “ DR. KELLY L TAYLOR DC” Practice Location

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