Provider Demographics
NPI:1538148580
Name:TAYLOR, ANTHONY J (MD)
Entity type:Individual
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First Name:ANTHONY
Middle Name:J
Last Name:TAYLOR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6333 CENTER DR
Mailing Address - Street 2:BLDG. 16
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4106
Mailing Address - Country:US
Mailing Address - Phone:757-466-3413
Mailing Address - Fax:757-466-1310
Practice Address - Street 1:120 KINGS WAY
Practice Address - Street 2:SUITE 3200
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2505
Practice Address - Country:US
Practice Address - Phone:757-251-0051
Practice Address - Fax:757-466-1310
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101021715208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA51352OtherSENTARA HEALTHCARE
VA332763OtherANTHEM BC BS
VA332763OtherANTHEM BC BS