MEDICARE: ROBERT B. TAYLOR

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	332H00000X	Eyewear Supplier	930	NC

General Provider Information

NPI Number	:	1730347709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT B. TAYLOR

Provider Business Mailing Address
First Line	:	PO BOX 878
Second Line	:
City	:	NORTH WILKESBORO
State	:	NC
Zip	:	28659-0878
Country	:	US
Telephone Number	:	336-838-2281
Fax Number	:

Provider Business Practice Location Address
First Line	:	826 C ST
Second Line	:
City	:	NORTH WILKESBORO
State	:	NC
Zip	:	28659-4118
Country	:	US
Telephone Number	:	336-838-2281
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT B, TAYLOR
Credential	:	OD
Telephone Number	:	336-838-2281

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	05/27/2008

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