Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME0066602 | FL |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | ME66602 | FL |
NPI | 1497859904 |
---|---|
Provider Name | Arthur Cortland Taliaferro |
First Address | St Augustine, FL 32086-5767 |
Second Address | St Augustine, FL 32086-5767 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 28/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040010602 | RR MEDICARE (01) | FL |
377005200 | (05) | FL |
F93742 | (02) |