Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 0101243976 | VA |
NPI | 1386849784 |
---|---|
Provider Name | Dr. Taylor Banks |
First Address | Portsmouth, VA 23708-2111 |
Second Address | Portsmouth, VA 23708-2111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 20/04/2020 |