Provider Demographics
NPI:1235525643
Name:TAYLOR, KATIE VERON (MD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:VERON
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HIGH LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-4335
Mailing Address - Country:US
Mailing Address - Phone:225-939-5141
Mailing Address - Fax:
Practice Address - Street 1:5246 BRITTANY DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9136
Practice Address - Country:US
Practice Address - Phone:225-767-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA326250207RI0200X
FLTRN27086207R00000X, 207RI0200X
LAINTERN PERMIT PENDIN207R00000X
FLME145217207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2391313Medicaid