Provider Demographics
NPI:1669460556
Name:TAYLOR, GEORGE PEACH JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PEACH
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6341 RIVER DOWNS RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-1559
Mailing Address - Country:US
Mailing Address - Phone:703-658-3020
Mailing Address - Fax:
Practice Address - Street 1:HQ USAF/SG
Practice Address - Street 2:1780 AIR FORCE PENTAGON
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20330-1780
Practice Address - Country:US
Practice Address - Phone:703-692-6800
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF20532083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine