Taylor, Jackie L.

Taylor, Jackie L. is an individual health care provider with primary practice located at 708 W Forest Ave , Jackson TN 38301-3901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Taylor, Jackie L. can be contacted via phone (731) 660-8759.

Contact Information

Primary practice address
708 W Forest Ave Jackson TN 38301-3901
Phone: (731) 660-8759
Fax: (731) 660-8739
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD18902 Tennessee

Profile Details

NPI number 1710966130
LBN Legal business name Taylor, Jackie L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2006
Last updated Dec 2nd, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710966130 NPPES
Tennessee MEDICAID 3889596
Tennessee Other 4072420

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