Provider Demographics
NPI:1780887182
Name:MOSLEY, TAYLOR ALVIN (MD)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALVIN
Last Name:MOSLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-3425
Mailing Address - Country:US
Mailing Address - Phone:205-221-4705
Mailing Address - Fax:205-221-6653
Practice Address - Street 1:20 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3425
Practice Address - Country:US
Practice Address - Phone:205-221-4705
Practice Address - Fax:205-221-6653
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2010-05-19
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Provider Licenses
StateLicense IDTaxonomies
AL28293207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1871710614Medicaid