Taylor Johnson Smith, PA-C
Physician Assistant in Louisville, KY. Individual provider (NPI-1).
NPI number1730730516
StatusActive
Last updated in NPPESOct 27, 2020
Details
- NPI
- 1730730516
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Taylor Johnson Smith
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 24, 2019
- Certification date
- Oct 27, 2020
- Last updated
- Oct 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | TC866 | KY | Yes |
| 207RG0100X | Internal Medicine, Gastroenterology | TC866 | KY | |
| 363AM0700X | Physician Assistant, Medical | TC866 | KY |
Practice location
3999 Dutchmans Ln Ste 7bLouisville, KY 40207-4742
Phone 502-896-4711
Mailing address
Po Box 776351Chicago, IL 60677-6351
Phone 502-588-9490 · Fax 502-272-5116
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