Provider Demographics
NPI:1154507382
Name:TAYLOR, HAROLD DENNY (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:DENNY
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 1:100 SANDPIPER LN
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3386
Mailing Address - Country:US
Mailing Address - Phone:985-624-2340
Mailing Address - Fax:985-624-2341
Practice Address - Street 1:64030 HIGHWAY 434
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445-3456
Practice Address - Country:US
Practice Address - Phone:985-624-2340
Practice Address - Fax:985-624-2341
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.03930R2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1302147Medicaid
LA4N043DE03Medicare PIN