MEDICARE: DR. ALEX P TAYLOR M.D.

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	207Q00000X	Family Medicine Physician	0101231062	VA

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	:	1881654192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX P TAYLOR M.D.

Provider Business Mailing Address
First Line	:	930 MAJESTIC AVE
Second Line	:	SUITE 210
City	:	NORFOLK
State	:	VA
Zip	:	23504-4055
Country	:	US
Telephone Number	:	757-622-0453
Fax Number	:	757-622-0455

Provider Business Practice Location Address
First Line	:	930 MAJESTIC AVE
Second Line	:	SUITE 210
City	:	NORFOLK
State	:	VA
Zip	:	23504-4055
Country	:	US
Telephone Number	:	757-622-0453
Fax Number	:	757-622-0455

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	12/03/2014

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