Provider Demographics
NPI:1013141431
Name:TAYLOR, KENT EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:EDWARD
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1140 LEXINGTON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9330
Mailing Address - Country:US
Mailing Address - Phone:502-868-1100
Mailing Address - Fax:502-868-5612
Practice Address - Street 1:1140 LEXINGTON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9330
Practice Address - Country:US
Practice Address - Phone:502-868-1100
Practice Address - Fax:502-868-5612
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY45430207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-64895OtherBCBSOF AL
KYK144250OtherMEDICARE
AL174934Medicaid
AL511-64888OtherBCBS OF AL
KY7100219510Medicaid
AL102I117251OtherMEDICARE
AL175567Medicaid
AL511-64894OtherBCBS OF AL