Provider Demographics
NPI:1770080574
Name:TAYLOR, JOHN COREY (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:COREY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:ISOM
Mailing Address - State:KY
Mailing Address - Zip Code:41824-0430
Mailing Address - Country:US
Mailing Address - Phone:606-634-8428
Mailing Address - Fax:
Practice Address - Street 1:750 MORTON BLVD.
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701
Practice Address - Country:US
Practice Address - Phone:606-439-3557
Practice Address - Fax:606-436-6988
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04968207P00000X, 207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program