MEDICARE: MS. KIMBERLY M TAYLOR

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	225100000X	Physical Therapist	08564	GA

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	:	1982819629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY M TAYLOR

Provider Business Mailing Address
First Line	:	1407 AYLESBURY DR
Second Line	:
City	:	EVANS
State	:	GA
Zip	:	30809-8214
Country	:	US
Telephone Number	:	706-825-7527
Fax Number	:

Provider Business Practice Location Address
First Line	:	3712 EXECUTIVE CENTER DR
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-5095
Country	:	US
Telephone Number	:	706-825-7527
Fax Number	:

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	03/23/2026

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