Provider Demographics
NPI:1689776296
Name:TAYLOR, ROBERT DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DEAN
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 1:154 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016
Mailing Address - Country:US
Mailing Address - Phone:256-586-2976
Mailing Address - Fax:256-586-2121
Practice Address - Street 1:154 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016
Practice Address - Country:US
Practice Address - Phone:256-586-2976
Practice Address - Fax:256-586-2121
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9295207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL10452Medicaid
C72852Medicare UPIN
AL10452Medicare ID - Type Unspecified