MEDICARE: ROBERT W TAYLOR JR. MD

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	207RP1001X	Pulmonary Disease Physician	013333	LA

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

General Provider Information

NPI Number	:	1821198052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT W TAYLOR JR. MD

Provider Business Mailing Address
First Line	:	2551 GREENWOOD ROAD
Second Line	:	STE 210
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-3905
Country	:	US
Telephone Number	:	318-635-0834
Fax Number	:	318-636-2331

Provider Business Practice Location Address
First Line	:	2551 GREENWOOD ROAD
Second Line	:	STE 210
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-3905
Country	:	US
Telephone Number	:	318-635-0834
Fax Number	:	318-636-2331

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/08/2007

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