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NPI Code Detail

MEDICARE: TAYLOR BROOKE DILLINGHAM

MEDICARE: TAYLOR BROOKE DILLINGHAM
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
1156FX1800XOptician281348

General Provider Information

NPI Number : 1811698749
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR BROOKE DILLINGHAM
Provider Business Mailing Address
First Line : 2345 HAPPY VALLEY RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-8076
Country : US
Telephone Number : 270-308-4398
Fax Number : 270-678-2647
Provider Business Practice Location Address
First Line : 2345 HAPPY VALLEY RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-8076
Country : US
Telephone Number : 270-678-5250
Fax Number : 270-678-2647
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2023
Last Update Date : 03/16/2023

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Directions to “ TAYLOR BROOKE DILLINGHAM ” Practice Location

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