Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 016705 | LA |
NPI | 1003852302 |
---|---|
Provider Name | Robert Stewart Taylor |
First Address | Baton Rouge, LA 70810-7827 |
Second Address | Baton Rouge, LA 70810-7827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 23/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1370037 | (05) | LA |
B64612 | (02) |