Basic Information
| Provider Information | |||||||||
| NPI: | 1346274461 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5555 PEACHTREE DUNWOODY RD | ||||||||
| Address2: | STE G99 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048433323 | ||||||||
| FaxNumber: | 4045745944 | ||||||||
| Practice Location | |||||||||
| Address1: | 5555 PEACHTREE DUNWOODY RD | ||||||||
| Address2: | STE G99 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048433323 | ||||||||
| FaxNumber: | 4045745944 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 05/20/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | 054132 | GA | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 184753168A | 05 | GA | MEDICAID |