Provider Demographics
NPI:1114987260
Name:TAYLOR, JAMES D (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7367 TWO NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7619
Mailing Address - Country:US
Mailing Address - Phone:803-788-1335
Mailing Address - Fax:803-788-6954
Practice Address - Street 1:7367 TWO NOTCH RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7619
Practice Address - Country:US
Practice Address - Phone:803-788-1335
Practice Address - Fax:803-788-6954
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC838152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1093836124Medicare NSC
SCU35567Medicare UPIN
SC1497714240Medicare NSC