Provider Demographics
NPI:1376374215
Name:TAYLOR REGIONAL MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:TAYLOR REGIONAL MEDICAL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER ASST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:SNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-789-6100
Mailing Address - Street 1:1698 OLD LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-3319
Mailing Address - Country:US
Mailing Address - Phone:270-465-3561
Mailing Address - Fax:
Practice Address - Street 1:363 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-1270
Practice Address - Country:US
Practice Address - Phone:270-384-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-12
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty