Provider Demographics
NPI:1124061346
Name:TAYLOR, DANA A (MD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 SE MAGNOLIA EXT UNIT 1
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-3770
Mailing Address - Country:US
Mailing Address - Phone:352-401-1218
Mailing Address - Fax:352-690-6954
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:STE 270
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1527
Practice Address - Country:US
Practice Address - Phone:865-251-4658
Practice Address - Fax:865-251-4659
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000380342086S0127X
FLME1381012086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3892121Medicaid
TN3892121Medicare ID - Type Unspecified