Provider Demographics
NPI:1659446326
Name:TAYLOR, WILLIAM E (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
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 1:1900 10TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3602
Mailing Address - Country:US
Mailing Address - Phone:706-984-7400
Mailing Address - Fax:706-984-7401
Practice Address - Street 1:1900 10TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3602
Practice Address - Country:US
Practice Address - Phone:706-984-7400
Practice Address - Fax:706-984-7401
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA51747208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000954423Medicaid
GA02BDJHSOtherMEDICARE PTAN
AL150383Medicaid