Provider Demographics
NPI:1447214325
Name:TAYLOR, PAULA FLANAGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:FLANAGAN
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 1:205 COOPERHAWK LANE
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1868
Mailing Address - Country:US
Mailing Address - Phone:304-776-6967
Mailing Address - Fax:
Practice Address - Street 1:333 LAIDLEY ST
Practice Address - Street 2:SAINT FRANCIS FIRST HEALTH WELLNESS CENTER
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1614
Practice Address - Country:US
Practice Address - Phone:681-313-4824
Practice Address - Fax:681-313-4825
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20038207P00000X, 207RH0002X
WV20036207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1805986-000Medicaid
WV1805986000Medicaid
WVB441OtherGROUP MEDICARE
110239880OtherRAILROAD MEDICARE
WV3810024049OtherGROUP MEDICAID
WVTA4045873Medicare ID - Type Unspecified
H34238Medicare UPIN
WV1805986000Medicaid
TA4045879Medicare PIN
IN9286133Medicare PIN
WVB441OtherGROUP MEDICARE
WV3810024049OtherGROUP MEDICAID
110239880Medicare PIN