Provider Demographics
NPI:1346278793
Name:CAFFEY, TAYLOR D (MD PA)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:D
Last Name:CAFFEY
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 JAMES STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360
Mailing Address - Country:US
Mailing Address - Phone:334-774-8483
Mailing Address - Fax:334-774-5742
Practice Address - Street 1:370 JAMES STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360
Practice Address - Country:US
Practice Address - Phone:334-774-8483
Practice Address - Fax:334-774-5742
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000000908Medicaid
C69990Medicare UPIN
AL000000908Medicaid