Provider Demographics
NPI:1659414522
Name:TAYLOR, ELIZABETH S (MD, MASTERSPUBHLTH)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:S
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD, MASTERSPUBHLTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6765 CORPORATE BLVD., #5306
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:422 COLONIAL DR
Practice Address - Street 2:COMMUNITY EMPOWERMENT SERVICES
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6505
Practice Address - Country:US
Practice Address - Phone:225-292-5151
Practice Address - Fax:225-292-5152
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD15104R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1038938Medicaid
LAFT4000078OtherDEA
LA1038938Medicaid