Provider Demographics
NPI:1972645356
Name:TAYLOR, PERRY D JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:D
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 FINZER ST
Mailing Address - Street 2:#109
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2400
Mailing Address - Country:US
Mailing Address - Phone:502-562-3133
Mailing Address - Fax:
Practice Address - Street 1:419 FINZER ST
Practice Address - Street 2:#109
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2400
Practice Address - Country:US
Practice Address - Phone:502-562-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206730183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist