Provider Demographics
NPI:1376631770
Name:TAYLOR, RONALD EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:EUGENE
Last Name:TAYLOR
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:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-691-8070
Mailing Address - Fax:270-685-5467
Practice Address - Street 1:1325 TRIPLETT ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3163
Practice Address - Country:US
Practice Address - Phone:270-686-8500
Practice Address - Fax:270-685-5467
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY19120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00000914393OtherANTHEM, OHMG
KY64191208Medicaid
000000047224OtherANTHEM
IN100377650Medicaid
1024OtherBLUE CROSS/ BLUE SHIELD
KY00000914393OtherANTHEM, OHMG
1024OtherBLUE CROSS/ BLUE SHIELD