Provider Demographics
NPI:1407099450
Name:TAYLOR OBSTETRICS AND GYNECOLOGY CLINIC PLLC
Entity Type:Organization
Organization Name:TAYLOR OBSTETRICS AND GYNECOLOGY CLINIC PLLC
Other - Org Name:TAYLOR OBSTETRICS AND GYNECOLOGY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-217-0517
Mailing Address - Street 1:9601 LILE DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6321
Mailing Address - Country:US
Mailing Address - Phone:501-217-0517
Mailing Address - Fax:501-227-5187
Practice Address - Street 1:9601 LILE DR
Practice Address - Street 2:SUITE 800
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6321
Practice Address - Country:US
Practice Address - Phone:501-217-0517
Practice Address - Fax:501-227-5187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-2008207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty