Provider Demographics
NPI:1033163183
Name:TAYLOR, GAYNEL BARRY (MD)
Entity Type:Individual
Prefix:
First Name:GAYNEL
Middle Name:BARRY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1928
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-1928
Mailing Address - Country:US
Mailing Address - Phone:334-677-5986
Mailing Address - Fax:334-677-4901
Practice Address - Street 1:1206 COLUMBIA HWY
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1826
Practice Address - Country:US
Practice Address - Phone:334-677-5986
Practice Address - Fax:334-677-4901
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00010992207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09440OtherBC BS OF FLORIDA
AL000031531Medicaid
AL51031531OtherBCBS OF ALABAMA
AL000031531Medicaid
AL80188385Medicare PIN