Provider Demographics
NPI:1164540712
Name:TAYLORMOORE, JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:TAYLORMOORE
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 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:WW 1.5, DEPT OF OPHTHALMOLOGY
Mailing Address - City:WASHINGTON, DC
Mailing Address - State:DC
Mailing Address - Zip Code:20010-1433
Mailing Address - Country:US
Mailing Address - Phone:202-476-3017
Mailing Address - Fax:
Practice Address - Street 1:3023 HAMAKER CT STE 500
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2241
Practice Address - Country:US
Practice Address - Phone:703-876-2788
Practice Address - Fax:571-776-3190
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035648207WX0110X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology