Provider Demographics
NPI:1144539800
Name:TAYLOR, HAROLD JONES JR (CSA)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:JONES
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2516
Mailing Address - Country:US
Mailing Address - Phone:678-468-9851
Mailing Address - Fax:
Practice Address - Street 1:2005 NORTH RD
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2562
Practice Address - Country:US
Practice Address - Phone:678-468-9851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor