Provider Demographics
NPI:1750583134
Name:TAYLOR, BYRON D (MD)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:D
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 1:985 AZALEE WHARTON AVE NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-4573
Mailing Address - Country:US
Mailing Address - Phone:662-312-7611
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:PO BOX 76295
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30358-1295
Practice Address - Country:US
Practice Address - Phone:888-717-0080
Practice Address - Fax:404-549-2853
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA66331207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102697344Medicaid
PAP01036036OtherRAILROAD MEDICARE
PA236365Medicare PIN