Provider Demographics
NPI:1033564323
Name:TAYLOR REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:TAYLOR REGIONAL HOSPITAL
Other - Org Name:TAYLOR EXPRESS CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCGINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-783-0262
Mailing Address - Street 1:PO BOX 1297
Mailing Address - Street 2:
Mailing Address - City:HAWKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31036-7297
Mailing Address - Country:US
Mailing Address - Phone:478-783-9340
Mailing Address - Fax:478-783-3730
Practice Address - Street 1:222 PERRY HWY
Practice Address - Street 2:BLDG A STE 102
Practice Address - City:HAWKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31036-6748
Practice Address - Country:US
Practice Address - Phone:478-783-2273
Practice Address - Fax:478-783-2272
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAYLOR REGIONAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty