Provider Demographics
NPI:1275668170
Name:JEFFREY L TAYLOR, O.D.AND LYNN C TAYLOR O.D., PA
Entity Type:Organization
Organization Name:JEFFREY L TAYLOR, O.D.AND LYNN C TAYLOR O.D., PA
Other - Org Name:ANDREWS FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:828-321-2020
Mailing Address - Street 1:PO BOX 2645
Mailing Address - Street 2:29 CHESTNUT STREET
Mailing Address - City:ANDREWS
Mailing Address - State:NC
Mailing Address - Zip Code:28901-2645
Mailing Address - Country:US
Mailing Address - Phone:828-321-2020
Mailing Address - Fax:828-321-4897
Practice Address - Street 1:29 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:NC
Practice Address - Zip Code:28901-2645
Practice Address - Country:US
Practice Address - Phone:828-321-2020
Practice Address - Fax:828-321-4897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1607 AND 1592152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCH4108OtherRAILROAD MEDICARE
NC890922TMedicaid
NC5501380001Medicare NSC
NCU57499Medicare UPIN
NC890922TMedicaid