Provider Demographics
NPI:1457115461
Name:TAYLOR, BILLY WARD III
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:WARD
Last Name:TAYLOR
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 1/2 HALL ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-1905
Mailing Address - Country:US
Mailing Address - Phone:904-762-7520
Mailing Address - Fax:
Practice Address - Street 1:521 1/2 HALL ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-1905
Practice Address - Country:US
Practice Address - Phone:904-762-7520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant