Provider Demographics
NPI:1366787723
Name:TAYLOR, LINDSEY HELEN (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:HELEN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:HELEN
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5505 ROSWELL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1985
Mailing Address - Country:US
Mailing Address - Phone:404-480-9330
Mailing Address - Fax:404-480-4233
Practice Address - Street 1:5505 ROSWELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1985
Practice Address - Country:US
Practice Address - Phone:404-480-9330
Practice Address - Fax:404-480-4233
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6694207XX0005X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty