MEDICARE: TAYLOR DOGGETT

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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1851084529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR DOGGETT

Provider Business Mailing Address
First Line	:	1459 SAINT ROSE AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-1078
Country	:	US
Telephone Number	:	318-792-1184
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 HOSPITAL RD
Second Line	:
City	:	NEW ROADS
State	:	LA
Zip	:	70760-2621
Country	:	US
Telephone Number	:	225-310-6501
Fax Number	:

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

Provider Enumeration Date	:	05/30/2023
Last Update Date	:	05/30/2023

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Directions to “ TAYLOR DOGGETT ” Practice Location

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