Provider Demographics
NPI:1457675241
Name:TAYLOR, WILLIAM FARNHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FARNHAM
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 1:175 CARRIAGE CLUB DR
Mailing Address - Street 2:6-301
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9003
Mailing Address - Country:US
Mailing Address - Phone:704-577-2114
Mailing Address - Fax:
Practice Address - Street 1:175 CARRIAGE CLUB DR
Practice Address - Street 2:6-301
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9003
Practice Address - Country:US
Practice Address - Phone:704-577-2114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39699207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-81894Medicaid
NC2159025BMedicare PIN
NC89-81894Medicaid