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NPI Code Detail

MEDICARE: DR. PEGGY BOYD TAYLOR DO

MEDICARE: DR. PEGGY BOYD TAYLOR DO
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
1207Q00000XFamily Medicine PhysicianR8699MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922094135
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PEGGY BOYD TAYLOR DO
Provider Business Mailing Address
First Line : 9352 OLIVE BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63132-3214
Country : US
Telephone Number : 314-993-5344
Fax Number : 314-993-8207
Provider Business Practice Location Address
First Line : 9352 OLIVE BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63132-3214
Country : US
Telephone Number : 314-993-5344
Fax Number : 314-993-8207
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 11/17/2008

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