Provider Demographics
NPI:1518075969
Name:TAYLOR, HENRY PERCY (RPH)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:PERCY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 CITRUS BLVD APT 247
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123-7124
Mailing Address - Country:US
Mailing Address - Phone:504-736-9877
Mailing Address - Fax:504-738-5889
Practice Address - Street 1:8601 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70123-3510
Practice Address - Country:US
Practice Address - Phone:504-738-5785
Practice Address - Fax:504-738-5889
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10923183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1261424Medicaid