Provider Demographics
NPI:1548499031
Name:TAYLOR, LANDON CHRISTOPHER (DC)
Entity type:Individual
Prefix:DR
First Name:LANDON
Middle Name:CHRISTOPHER
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EASTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9797
Mailing Address - Country:US
Mailing Address - Phone:502-868-0097
Mailing Address - Fax:502-868-7499
Practice Address - Street 1:100 EASTSIDE DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9797
Practice Address - Country:US
Practice Address - Phone:502-868-0097
Practice Address - Fax:502-868-7499
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5196111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100266610Medicaid
KYK093843Medicare PIN