Provider Demographics
NPI:1174651129
Name:EMILY BROWN TAYLOR PSC
Entity Type:Organization
Organization Name:EMILY BROWN TAYLOR PSC
Other - Org Name:EMILY BROWN TAYLOR PSC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:270-821-2862
Mailing Address - Street 1:344 E ARCH ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-2102
Mailing Address - Country:US
Mailing Address - Phone:270-821-2862
Mailing Address - Fax:
Practice Address - Street 1:344 E ARCH ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-2102
Practice Address - Country:US
Practice Address - Phone:270-821-2862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1137DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77903441Medicaid
KY77903441Medicaid
KY1174651129Medicare NSC