Provider Demographics
NPI:1851576557
Name:TAYLOR, DENISE S (DO)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:S
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1086 1/2 BAXTER ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6316
Mailing Address - Country:US
Mailing Address - Phone:706-353-0606
Mailing Address - Fax:706-353-0798
Practice Address - Street 1:1086 1/2 BAXTER ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6316
Practice Address - Country:US
Practice Address - Phone:706-353-0606
Practice Address - Fax:706-353-0798
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS105962084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001350700Medicaid
FL145J2OtherBCBS OF FLORIDA
FL8997272OtherCIGNA
FL9243248OtherAETNA
FLP00793294OtherRR MEDICARE
FLP00793294OtherRR MEDICARE